Rebecca S. Tuetken, MD
It remains unclear which if any of these post-mortem beliefs were jointly held as divinization and admission to an ancestral collective should be a positive outcome whereas consignment to Sheol was viewed negatively as an existence without Yahweh diabetes type 2 urine generic micronase 2.5mg fast delivery. Postulating successive stages in a transition from life to a possible an cestral collective blood sugar values chart buy 5mg micronase fast delivery, such as transitory residence in Sheol diabetes diet tamil nadu buy micronase cheap online, lacks any textual support diabetes y sus complicaciones purchase generic micronase canada. The Cave of Machpelah modeled the (possibly later) biblical ideal of patrilineal generations buried together on family-owned land. Diverging from the ideal, a very small num ber of high-status persons including Shebna the Royal Steward chose individualized entombment in Silwan over family burial (cf. In general, biblical texts display no interest in the physical tomb plan as a domicile for the dead, in mortuary provisions, or in consumption in the tomb by the dead and/or perhaps the living (except the much later Isa 65:4). For those bur ying in cave or bench tombs, standardization of the tomb plan, body treatment, and mortuary provisions reflects a widely-adopted cultural convention that views death as at least a temporary postmortem existence. Recumbent bodies mirror the sleeping but with the removal of bones to a repository or pit the individual loses his or her connection with the actions of the living. Tomb evidence for ritualized ancestor worship and a cult of the dead is am biguous. Vessels and items of personal identification accompanying primary as well as secondary interments suggest even the long dead were thought to continue a form of postmortem existence such that they were provisioned with common household items. No mortuary items reflect an elevation in status of the deceased Death and Burial in Eighth-Century Judah 375 from mortal to divinity. Based on biblical idioms for death, secondary remains within the tomb are presumed to represent the ancestral collective. Their idealized system broached no competition to the central authority and its patron deity from the dead. The proposed increasing hostility towards the dead left no identifiable mark on eighth through sixth century physical remains. Through this period, significant changes evident in the physical remains appear to counter rather than confirm a diminishing status of the dead. Burials now dis play a greater frequency of repositories and increasingly greater resources invested in entombment. Arnold Van Gennep (1960), as elaborated by Victor Turner (1969), identified three stages in the trajectory of the dead. The second and most significant, liminal stage represents the transformation from the separa tion to the third, postliminal stage of aggregation with reintegration into a community of the dead. For eighth-century Judahites, these stages have been cor related with pre-liminal death and placement in the tomb, liminal repose in the tomb as the flesh decomposes, and postliminal acceptance into the ancestral col lective represented by comingled bones. To join the ancestors may be a euphemism for an acceptable death; no Is raelite ancestral collective is either described or named in the Bible. Anthropological theory posits that the greater the disparity between the social 13 world and burials, the more burials present a construct divorced from reality. Theories of personhood explore relational identities and raise questions such as what aspect of the deceased was presented at burial. Cemeteries proximate to towns consist of side-by-side tombs with slight variations in layout, size, and relative wealth comparable to their resi dential counterparts. In the tombs, the deceased repose on benches, as in sleep, provisioned with common household items. The standardized assemblage, with no distinctive mortuary items, few tools, and no large storage vessels, provisions the recent and long-ago dead for temporary occupation but without the tedious subsistence chores. Continued life for the deceased, as indicated by material provisions, does not presuppose but permits ancestor veneration or worship and a cult of the dead. The Lives of Ordinary People in Ancient Israel: Where Archaeology and the Bible Intersect. The at times widely divergent interpretations of the remains from this famous site have significant im plications for the study of ancient Israelite religion and the Hebrew Bible writ large. The extensive scholarly literature on the site is now enriched im measurably by the recent publication of the long-awaited final excavation report (Meshel 2012), along with recent studies that have engaged directly with the final publication. In what follows, we provide *It is a pleasure to dedicate this short study to Oded Borowski, a gifted scholar, teacher, and field archaeologist. The brevity of the present essay is, therefore, in directly inverse proportion to the respect we have for him. That presentation was subsequently pub lished in more developed form in LeMon and Strawn 2013. Insofar as the present essay draws on that publication, interested readers are also referred to that article for additional discussion. Kuntillet Ajrud sits atop a hill that lies at a small crossroads about 15 kilo meters from the much larger road connecting Gaza to Eilat. The surrounding area is ex tremely arid and otherwise flat, with little capacity to support permanent settlements (see Meshel 2012a). Within that general time frame, it is clear that the site was occupied only briefly, perhaps just twenty-five years (so Keel and Religion in Eighth-Century Judah: the Case of Kuntillet Ajrud 381 Uehlinger 1998, 248 who give the range as ca. Since its discovery, Kuntillet Ajrud has remained a compelling locus for historians, generally, and for historians of religion, particularly, since the factors regarding its establish ment, use, and abandonment make it something of a time-capsule from a specific and important period in ancient Israelite religion. The two buildings on the site were positioned on the top of the hill, on the narrow western point of the summit. Both buildings have unique features that make it difficult to establish clear architectural parallels (see Meshel and Goren 2012). This building contained a large interior courtyard framed by storage rooms on the western and southern sides and is particularly notable for its complex of bench rooms at the eastern entrance of the structure. Entrance into Building A from the crossroads at the base of the hill involved going through Building B (see fig. This smaller building had two wings that created a corridor providing passage to the rest of the site and to Building A. Religion in Eighth-Century Judah: the Case of Kuntillet Ajrud 383 Building B, notably, had fully plas tered white walls.
Interestingly diabetes type 1 uncontrolled buy cheap micronase 5 mg online, these small fortified structures are more common in Judah than in Israel diabetes symptoms fatigue after eating purchase 2.5mg micronase amex, and this probably resulted from the less dense countryside diabetic hand pain generic micronase 5 mg, and the need for more security there diabetes type 2 micronase 5mg without a prescription. At any event, the mere existence of the large fortresses, like Arad, is indica tive of a sophisticated state apparatus at the time with at least a small core of a standing army (though this also is not a novelty of the eighth century). The wide spread appearance of the smaller fortified structures is also indicative of the scale 186 Avraham Faust of the kingdom and its control over the countryside, and this development is cou pled with the growth of the rural settlements at this time. This can be seen in the olive oil industry, which is easily identified ar chaeologically and can serve as a simple and good example. While agricultural production existed throughout history, it appears that far more surpluses were produced in this period than in the preceding centuries, and toward the end of this century, relatively large centers for the production of oil surpluses were unearthed in Judahite sites like Tell Beit Mirsim and Beth-Shemesh. Notably, increase in writing is part and parcel of the process of increase in standardized manufacture on the one hand, and it also leads to further alienation on the other, because it helps to "calculate, and convey worth in ways that have no direct link the actual object, but rather conceive of their values in both abstract and utilitarian ways (cf. It is quite clear, therefore, that the eighth century was quite developed tech nologically and that many processes that were initiated earlier matured then. Although peaking in the seventh century (Faust and Weiss 2011 and references), these processes were clearly underway at least by the late eighth century, if not earlier. Above all, it had an impact on the production of surpluses, which Judah used to pay for the imports that served the royalty as well as its tribute to Assyria (in the last third of the century). While socioeconomic stratification can be studied on the basis of various lines of analysis, architecture seems to be the best vehicle for such an enterprise. It appears that in a typical Ju dahite city there was small number of very large and wealthy structures, and many smaller and flimsier abodes. Their plan was created by local constraints and was influenced by them (with the exception of the adoption of the basic four room concept which served as a common characteristic). These structures most likely housed nuclear families, probably mem bers of the lower classes which comprised the majority in the urban sector. Still, one can identify in the cities also a small number of much larger and well-built structures. The house does not share walls with other structures, and it appears that whenever it was built besides other structures double walls were constructed. The structure was built at the top of the mound, in the highest point at the site near its southern edge, overlooking some of the fields and parts of roads that were located below the mound. Notably, when enough data is available, differences can also be identified on the basis of a sophisticated analysis of the finds within the houses. We found dozens of storage vessels within the various rooms, indicating the storage of surpluses, along with other items showing high status or position like sealings and bullae. Simplistically put, a society with no stratification will be represented by a straight line. The following graphs of Tell Beit Mirsim and Beth-Shemesh will serve as examples: Society and Culture in the Kingdom of Judah 189 Graph 3: Socioeconomic stratification at Tell Beit Mirsim. Society and Culture in the Kingdom of Judah 191 Graph 5: Socioeconomic stratification in the kingdom of Judah Graph 6: Socioeconomic stratification in the kingdom of Israel 192 Avraham Faust As far as Judah is concerned, the vast majority of the buildings are more or less identical, but towards the end of the graph there is a sudden jump in the qual ity and size of the buildings. This is clear evidence that Judahite cities were characterized by severe polarization between two classes: the small, wealthy up per class, and the poor lower class that was much larger. However, the absence of sharp jumps along the graph shows that in the kingdom of Israel there was a fuller socio-economic continuum, and it contained a sort of middle class. In Israel, therefore, there is a more apparent middle class than in Judah, and the graph is more complete. This seems to be in line with the above-mentioned difference in urbanization between the two kingdoms, and both show that Israel was a more complex polity than Judah. Ceramic traditions, for instance, express conti nuity in a number of traits, including the extreme rarity of decoration of pottery. Another example is the extensive use of the four-room house, and more could be added to this list. Still, there are a few traits that appear, at least in substantial numbers, for the first time in this era. In con trast, the eighth century experienced the adoption of rock hewn burial caves, at least by the middle segments of the society and its upper echelon. The typical Judahite tomb is composed of a hewn burial cave, usually with a dromos (fig. The chambers were usually dug in strait lines, although the quality and finish vary greatly. After entering the cave, one reaches a central passage, on three sides of which benches were left undug. The benches are organized like a (the Hebrew letter et); one facing the doorway, and two on the right and left side of the central passageway. On one of the inner corners, or below one of the benches, there is usually Society and Culture in the Kingdom of Judah 193 a repository, into which the bones of the deceased were collected for secondary burial. Many funerary gifts accompanied the burials, and these were also found in the repository. Evi dently, this type of burial was used by extended families for a number of generations. There is great variation in the size and execution of the caves, reflecting so cioeconomic differences. What is important for our purposes, however, is not the source or origin of the new practice, but the mere fact that it was adopted at this time; the issue will be elaborated below. The differences between the various tombs resemble the differences between the houses (only that the tomb, unlike the houses, does not represent the entire population, and hence is not representative of the entire socioeconomic spectrum). In both cases the differ ences represent socioeconomic differences, while the mere usage of a common style indicates that the population belonged to the same social group.
Tolerance of Fondaparinux in patients with generalized contact der matitis to heparin blood sugar diary printable purchase discount micronase. Fondaparinux is a safe alternative in case of heparin intolerance during pregnancy diabetes mellitus type 2 medscape 2.5 mg micronase free shipping. Unexpected delayed-type hypersensitivity skin reactions to the ultra low-molecular-weight heparin fondaparinux diabetes tester order micronase 2.5 mg. Delayed-type hypersensitivity to the ultra-low molecular-weight heparin fon daparinux diabetes test melbourne order 2.5mg micronase with visa. Fondaparinux: a suitable alternative in cases of delayed-type allergy to hepa rins and semisynthetic heparinoids Hirudins Hirudins, proteins derived from the leech Hirudo medicinalis, specifically inhibit thrombin. Because of their completely dif ferent chemical structure compared with heparins, there in no cross-reactivity with heparins. S Management Alternative therapy: Argatroban, a synthetic thrombin inhibitor, was successfully used in patients with intolerance to heparin and hirudin. Anaphylactic and anaphylactoid reaction associated with lepirudin in patients with heparin-induced thrombocytopenia. S Diagnostic methods Skin tests Patch tests: 1% and 5% in pet on affected and unaffected skin (in fixed drug reaction) with positivity on affected skin. S Management Clopidogrel is nowadays the first-line platelet aggregation inhibitor. Cross-reactivity between ticlopidine and clopidogrel (2 thienopyridine drugs) is rare: switch to cilos tazol, aspirin, enoxaparin or warfarin. Rapid clearing of the skin eruption in most cases, even when the drug is not withdrawn. Rash with both clopidogrel and ticlopidine in two patients following percutaneous coronary intervention with drug-eluting stents. S Risk factors Protein C and protein S deficiencies, heparin-induced thrombocytopenia, factor V Leiden deficiency for skin necrosis. Cutaneous symptoms of bleeding: purpura, ecchymoses, haemorragic necrosis, vasculitis (with leucocytoclastic phenomen), alopecia (frequent). Warfarin-induced skin necrosis and leukocytoclastic vasculitis in a patient with acquired protein C and protein S deficiency. Strabismus surgery may be performed with hyoscine or glycopyrronium after skin tests. In the treatment of organophosphoric intoxication, use glycopyrrolate/diazepam or midazolam or scopolamine. Three important problems: Q Beta-blockers and asthma Q Beta-blockers and anaphylactic shock Q Beta-blockers and local allergic effect S Incidence One 40 or 80 mg tablet of propranolol can induce bronchoconstriction in 50% of asthmatics, but the rate is probably much lower with cardioselective beta-blockers. Beta-blockers in eye-drops are widely used for the treatment of glaucoma; the local allergic effect has recently been recognized. Topical use: contact dermatitis with beta-blocker-containing eye-drops (eyelid eczema and conjunc tivitis) and possibly systemic manifestations with oral beta-blockers. Beta-blockers decrease endogenous adrenaline secretion by blocking beta-2-receptors at synapses, and inhibit beta 1 effects of exogenous and endogenous adrenaline on the heart. In contact allergy, beta-blockers, having a very similar structure, are cross-reacting. When necessary, tolerance can be determined by quantitative measurement of cardioselectivity. Association between beta-blockers, other antihypertensive drugs and psoria sis: population-based case-control study. Epidermal necrolysis secondary to timolol, dorzolamide and latanoprost eye drops. The effect of topical ophthalmic instillation of timolol and betaxolol on lung function in asthmatic subjects. S Diagnostic methods Skin tests Prick tests: with a saturated solution of topical bovine thrombin in normal saline (positive in one patient). Anaphylaxis from topical bovine thrombin (Thrombostat*) during haemodialysis and evaluation of sensitization among a dialysis population. Calcium channel blockers are classified in 3 classes: Q Dihydropyridines: amlodipine, felodipine, isradipine, lacidipine, nicardipine, nifedipine, nimodipine, nitrendipine and nisoldipine. Drug re-challenge with nifedipine or verapamil in diltiazem reactor patients is rarely positive. Conversely, one patient with non-thrombocytopenic purpura due to nifedipine had a similar eruption with diltiazem; another patient with pruritic exanthema after diltiazem had a recurrence after amlodipine. Cutaneous reactions due to diltiazem and cross reactivity with other calcium channel blockers. Maculopapular rash induced by diltiazem: allergological investigations in four patients and cross-reactions between calcium channel blockers. The spectrum of cutaneous reactions associated with diltiazem: three cases and a review of the literature. S Incidence Allergic contact dermatitis in 14-38% after transdermal clonidine patch. Transdermal clonidine patch: local reaction, allergic contac dermatitis, pseudo lymphoma. S Diagnostic methods Skin tests Patch tests (transdermal preparation containing clonidine): positive in a patient who had reacted to transdermal, oral and intravenous clonidine. S Mechanisms Cross-reactive photoallergy to ketoprofen and fenofibrate can be explained by the common ben zoly-ketone structure of these compounds. An association between systemic photosensitivity to fenofibrate and photocontact sensitivity to ketoprofen, tiaprofenic acid, benzophenone and oxybenzone seems to exist. Results of a French nationwide survey of cutaneous side effects of ketopro fen gel reported between September 1996 and August 2000 (Article in French). Intradermal skin tests (1%): positive for furosemide as well as for chlorothiazide, bumetanide and sulfamethoxazole-trimethoprim (in one patient). Furosemide challenge in patients with heart failure and adverse reactions to sulfa containing diuretics.
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