Participants: N. David Emerson
Series Code: WM
Program Code: WM000435
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00:01 The following program presents principles designed to promote
00:03 good health and is not intended to take the place 00:05 of personalized professional care. 00:08 The opinions and ideas expressed 00:10 are those of the speaker. 00:12 Viewers are encouraged to draw their own conclusions 00:14 about the information presented. 00:36 Hello, I'm Dr. Emerson. 00:38 I am Medical Director at Eden Valley Lifestyle Center. 00:41 And today I wanted to take up a discussion again on fevers 00:45 and the beneficial effects they have 00:47 in fighting infections and even cancers. 00:51 Last time we were together we looked at some evidence 00:55 that titters were actually beneficial. 00:58 We looked at some of the work Louis Pasteur did 01:00 with anthrax, he found that 01:02 he could induce anthrax in cows and sheep, 01:05 but was unable to induce it into chickens. 01:08 He found that chickens had a higher temperature 01:11 than cows and sheep. 01:12 Cows and sheep being 38 degrees Celsius, 01:14 chickens being 40 to 42 degrees Celsius. 01:17 And he found that if he cooled the chicken down 01:20 in a water bath and gave it anthrax through an injection 01:23 instead of ignoring it, which was the usual case, 01:26 the chicken was dead in 24 hours. 01:29 Took another chicken infected him with the anthrax vaccine 01:32 in the cooling bath, when he started to show 01:34 symptoms after a couple of hours of anthrax toxicity, 01:37 he took him out of the bath, dried him off, 01:39 warmed him up chicken survived. 01:41 Just a few degrees Celsius made the difference between 01:44 life and death in the chicken's fight 01:46 against Anthrax. 01:48 Then we looked at the work of Wagner-Jauregg 01:52 who found that syphilis caused a progressive paralysis 01:57 and that, in countries like China and India 02:01 where syphilis was ramped, it very rarely progressed 02:04 to this progressive paralysis. 02:08 He hypothesized that the malaria that was endemic 02:11 in these places as well was causing fevers 02:14 that were possibly treating the syphilis. 02:18 So in 1917, he took nine patients 02:22 with progressive paralysis from syphilis, 02:26 which was considering incurable at that time, 02:28 he injected them all with malaria, 02:30 of course you can't do that today. 02:32 But that's what he did at that time, 02:34 induced the fever, three out of the nine people 02:37 the paralysis result. 02:40 He then treated their malaria with Quinine. 02:44 He was so successful that they treated 02:45 thousands of patients that had progressive paralysis 02:49 from syphilis with the malarial treatments. 02:53 And the success rate was consistently about 30%, 02:58 and he was so successful that this was became 03:03 a standard treatment at that time. 03:06 This sounded a bit strange and yet the scientific community 03:10 apparently didn't think it so strange because in 1927, 03:13 he received the Nobel Prize in Medicine and Physiology 03:17 for his work in treating syphilis with malaria fevers. 03:24 Have other diseases been treated with fever therapy, 03:29 actually typhoid vaccine was used to treat resistant 03:32 forms of gonorrhea, this produce fevers 03:36 over 40 degrees Celsius or about 140 degrees Fahrenheit 03:40 and these were modernly successful. 03:42 However there were side-effects 03:43 from the typhoid vaccine. 03:45 This is a gram negative bacteria, 03:47 and could produce not only fever 03:49 but occasionally hypotension or shock, 03:52 needless to say we don't use 03:53 that form of hyperthermia today. 03:57 Is there more evidence that regarding 04:00 the beneficial effects of fever. 04:02 Well, we wanna look at the work of Matt Kluger 04:05 who did control trials to study 04:07 the effect of fevers in infected animals. 04:10 His work was summarized in a very good review 04:15 in the Journal Science in 1984. 04:21 To study fevers in animals however he needed an animal 04:25 whose temperature he could control fairly easily. 04:28 And he found this in the ectoderm the dorsalis lizard. 04:33 Now lizards are ectoderms, that means the only way 04:35 they can change their temperature is were it moved 04:37 to a warmer climate to get warmer, 04:39 or move to a shadier, cooler climate to get cooler. 04:43 He setup a sandbar, he had a shade on one end, 04:47 he had sunlamps on the other and he had a little lizards 04:50 running in between these two equal climes 04:54 and he had a thermocouple in the rectums of these, 04:57 these would measure the temperature and give him 04:59 a read out of the lizard's temperatures moment by moment. 05:04 He found that, when they were healthy, 05:06 they would migrate between the shade in the sunlamps 05:08 to an area where the temperature would be about 05:11 38 degrees Celsius and this is what, what they preferred. 05:13 This is what they liked. 05:15 When however, he gave them a bacteria 05:19 and caused them to get sick, their thermostat inside 05:23 was turned up and they desired a warmer clime 05:26 and they migrated toward the lamp 05:28 and their temperatures rose to 40-42 degrees Celsius, 05:33 they then would recover and move back to the cooler clime, 05:37 their body temperature would again drop to about 05:39 38 degrees Celsius, which was their normal body temperature. 05:43 In a later experiment then he took several groups of lizards 05:46 infected them all with this bacteria. 05:50 But then he prevented some of them from going 05:53 to the warmer climes and he had 05:55 different climates for these lizards. 06:00 Some were able to go up to 42 degrees Celsius 06:03 in a three days, their mortality was, 06:06 or their survival actually was 95% 06:10 those that he kept at say 40 degrees Celsius 06:14 their mortality, their survival at 06:17 three and half days was 70%. 06:20 If he kept them at a lower temperature 38 degrees Celsius 06:23 which was their normal body temperature only 30% 06:27 survived by three and half days. 06:29 If he kept them cooler than normal temperature 06:31 at 36 degrees 25% survived at three days and half. 06:36 And if he kept them cooler at 34 degrees Celsius, 06:40 none of them survived at the end of three and half days. 06:43 So, if fever were found then to be therapeutic in lizards 06:50 what about the practice of giving aspirin 06:52 to suppress a fever, while he looked at this, 06:55 he infused aspirin into a group of lizards 07:00 and then another group of lizards he did, 07:02 he gave them no aspirin and he infected 07:04 them both with this bacteria. 07:07 He found that the lizards that again did not have 07:10 the aspirin migrated to a warmer clime 07:13 42 degrees Celsius and recovered and survived. 07:17 Those that have the aspirin, their thermostat was not reset 07:20 to a higher level, they did not migrate 07:23 to the higher temperature, they stayed around 07:26 38 degrees were cooler and they all died, 07:30 100% died by three and half days. 07:36 This beneficial effect of fevers 07:38 was also documented in goldfish. 07:41 Goldfish are found to live in a certain clime in the water, 07:50 of course if you dove into a lake in the summer 07:54 you find that the deeper you go the colder the water gets. 07:57 Well, fish would go down low for cooler temperatures, 08:00 they would raise higher for warmer temperatures. 08:03 And it was found that when there were infected, 08:05 the fish would move to a higher temperature clime 08:09 about five degrees centigrade higher, 08:11 they would fight the infection, 08:13 recover from the infection 08:15 and then move back down to their cooler clime. 08:18 If they were prevented again from migrating 08:21 to the warmer temperatures their mortality increased 08:26 and the immortality increased in direct proportion 08:29 to how much lower their temperature 08:33 was kept after the infection. 08:36 So the lower the temperature 08:37 the greater the mortality in goldfish. 08:40 Well, so far we've been talking about reptiles, 08:45 can this beneficial effect of fevers 08:47 also be seen in mammals. 08:50 Well, they did a co-related study in 1977, 08:53 they looked at ferrets, which are mammals, 08:56 and they infected them with an influenza virus. 08:59 Now they tested for the presence of the virus 09:02 with nasal washings and they would screen 09:05 those for the presence of the virus. 09:08 And they found that when they measured 09:11 the rectal temperatures of the ferrets that, 09:14 if the ferrets that got the highest temperatures 09:17 spontaneously resolved their viral infection faster, 09:22 those that had lower temperatures were not healing 09:25 at the higher temperature fevers clearer 09:27 their virus more slowly. 09:29 And these were statistically significant findings. 09:34 They did another test with mice, 09:37 what they found with mice, a newborn mice 09:41 their temperatures are typically lower 09:44 than temperatures of mice eight to nine days old. 09:48 If these newborn mice get Coxsackie B1 virus 09:53 it's usually fatal. 09:56 However, if they are eight to nine days old 09:58 and have this higher temperature, 10:00 they usually survive. 10:03 So they took a group of newborn mice, 10:07 they infected them with a Coxsackie B virus, 10:10 and half of them they incubated, 10:12 put them in rooms at 34 degrees Celsius 10:16 to increase their temperature, their mortality dropped 10:19 dramatically compared with those that were kept in rooms 10:23 at 22 to 24 degrees Celsius. 10:27 They then moved to puppies, and they found 10:30 similar response, similar findings. 10:35 They found that newborn puppies, 10:36 if they don't get mother's maternal antigens 10:39 through the mother's milk. 10:41 If they're infected with herpes canine virus 10:43 as newborn puppies, they die 100%. 10:47 On the other hand, if they are infected 10:52 at two weeks or more, their temperatures are higher, 10:55 they're able to mount fevers and they get 10:57 a little running nose, 10:58 it doesn't effect them, significantly. 11:02 So they took a group of newborn puppies 11:04 and they hypothesized that maybe this higher temperature 11:06 was protective, so they took the newborn puppies, 11:08 infected them all with herpes canine virus. 11:11 Half of them they kept at room temperature, 11:14 half of them they incubated kept their 11:15 temperatures higher, and they found 11:18 that those that were at room temperature 100% 11:23 of them were dead by day nine. 11:26 Where as those that were incubated by the ninth day 11:29 they were all still alive. 11:32 They found that just a temperature difference 11:36 going from 95 to 98.5 degrees Fahrenheit up to 11:41 101 to 103 degrees Fahrenheit was a difference between 11:44 life and death for these puppies 11:46 that were infected with the herpes canine virus. 11:49 Well, when they did autopsies on the ones that died 11:53 and then they sacrificed ones that lived 11:55 or a few of them died after nine days, 11:58 they found that ones that were unincubated, 12:01 they had wide spread areas of focal necrosis, 12:04 this is small areas of dead tissue 12:07 and hemorrhage or bleeding throughout the body. 12:09 A lung showed mild conjunction, 12:11 a few areas of consolidation consistent with pneumonia. 12:15 Two of the puppies that have been incubated 12:17 that died after the nine days showed very little damage 12:22 on pathology studies, very little hemorrhage 12:27 and just very little pulmonary congestion as well. 12:31 That is they had markedly less tissue damage 12:34 than the unincubated dogs. 12:37 The sacrificed animals, those that had survived 12:39 in the later sacrifice showed barely 12:42 visible pathology findings. 12:45 So the newborn puppies who don't yet have 12:48 thermal regulation in place, which would induce the fever, 12:52 which could protect them, these succumbed 12:56 to the infections of herpes canine virus. 12:58 But these newborn puppies if they were incubated, 13:01 that incubation was life saving to them in most cases. 13:06 Now we'll look at some older dogs, 13:08 these are dogs in whom the thermal regulation 13:11 is already in place and functioning, 13:13 they have higher body temperatures 13:15 than newborn puppies. 13:17 The rectal temperatures generally run around 13:18 100.5 to a 102 degrees Fahrenheit, 13:22 these were all inoculated 13:23 again with herpes canine virus. 13:25 Some are allowed to maintain their normal body temperature 13:28 and their tissues did not show evidence of damage. 13:31 Further more a virus on -- when they were sacrificed 13:35 could not be isolated in their tissue, 13:38 but other dogs, older dogs were tranquilized 13:42 and their body temperature was lowered to about 13:45 94 to 97 degrees Fahrenheit for 45 to 48 hours, 13:50 they were then sacrificed on pathological exam, 13:53 these dogs, the virus was readily recovered in the liver, 13:57 in the spleen, lesser amounts were found 13:59 in the lymph nodes, in the lung, 14:00 the kidneys, the adrenal tissues. 14:03 The pathological studies were done using 14:07 fluorescent antibodies to adhere to 14:09 viruses infected locally in cells. 14:12 In the dogs that were, had the lower temperature 14:15 they found numerous discreet fluorescent foci, 14:19 could be seen in the livers, in the spleen, in the kidney. 14:22 But the dogs that kept their higher temperature 14:25 no fluorescent cells could be seen, 14:28 in other words there was no evidence 14:29 of viral infection in these cells. 14:33 Does this have application to humans? 14:36 Dr. Haahr wrote in 1977, he said, 14:43 "The human neonate especially if premature 14:45 also has a restricted temperature regulation 14:48 and unless his body temperature is kept around 14:50 37 degrees Celsius or higher susceptibility 14:54 to viral infections may develop. 14:56 This maybe one of the reasons why 14:58 generalized herpes-simplex infections 15:00 are greatly overrepresented in premature babies, 15:03 because the febrile response to premature is limited 15:06 it seems reasonable to use hyperthermia 15:08 as a therapeutic measure in cases of 15:11 suspected viral infections, this might reduce mortality 15:14 and severe sequelae virus infections in this age group." 15:20 And that was from Dr. Haahr, 1977. 15:24 So, we would like to ask at this point, 15:26 what causes a fever, or what is the mechanism 15:30 to produce a fever when the body is infected? 15:35 What we find is that, when tissue becomes infected, 15:38 the leukocytes, the white cells in the blood 15:40 sense this and release a protein called Interleukin 1 15:44 used to be called en-dogenous pyrogen, 15:48 that means a fire maker inside. 15:50 This stimulated the production of prostaglandins 15:53 which then crossed the blood-brain barrier 15:55 and signaled the brain, this causes the 15:58 autonomic nervous system to reset the thermostat 16:01 to a higher temperature. 16:03 This intricately designed system would indicate 16:07 that it was placed their by a loving God, 16:09 a loving Creator for our benefit. 16:13 This in itself applies that fever would be a benefit, 16:17 as there is a mechanism in place 16:19 to actually generate this fever. 16:21 Well, how does this fever mechanism play out 16:23 when we get infected? 16:25 Well, if we get infected what happen is the body temperature 16:30 thermostat resets itself let's say 102, 16:33 but you're at 98 degrees Fahrenheit, 16:36 and so you feel cold, this is your body's 16:39 way of saying, help me out, put on a blanket. 16:41 So you put on a blanket, start shaking, 16:43 you're chilling, you generate heat 16:44 from those muscle contractions, 16:46 your body temperature rises to a 102, 16:48 and now you feel comfortable 'cause your temperature 16:51 is now matched to your thermostat, 16:53 at least you feel you don't feel cold. 16:56 Now, if somebody touches you and says, 16:58 oh you're burning up, on't you feel hot, 17:00 you say no, I feel comfortable in terms of temperature. 17:05 Then your temperature is maintained 17:07 for as long as it takes to clear that infection, 17:10 when that infection is clearer, 17:11 your body thermostat resets itself at 98.6. 17:14 Now you feel hot, that's your body's 17:17 way of saying, help me out, 17:18 you throw off the covers, you break out in a sweat, 17:21 this lowers your temperature down to 98.6 17:24 and now you've gone through the cycle. 17:26 If we're in the hospital and trying to identify 17:28 an infecting organism and for the blood culture, 17:31 we wanna check that blood culture 17:32 as the temperature is climbing, 17:34 because that's when the infecting agent 17:36 is still in the blood. 17:37 If you catch the, if you did the blood culture 17:40 when the temperature's decreasing you are less likely 17:44 to get a positive culture because the agent 17:46 has already been cleared through 17:48 that cycle of fever and then chills. 17:54 How do fevers help fight infections? 17:57 Well, one of the simplest mechanisms of course 18:00 would be the direct effect of an higher temperature 18:04 being lethal to bacterial outright. 18:06 And many bacteria do grow at slower temperatures, 18:09 excuse me, grow slower at febrile temperatures. 18:12 Some of the strains of pneumococci are killed 18:14 outright by temperatures as low as 18:17 41 to 41.5 degrees Celsius. 18:20 Rabbits maintain a normal temperature around 18:22 39.5 degrees Celsius, and their fevers can reach 18:27 as high as 42 degrees Celsius, which would be 18:29 high enough to kill pneumococci outright. 18:33 Now remember that fever therapy 18:36 was used successful to resolve many cases 18:39 of neurosyphilis and resistant forms of gonorrhea. 18:43 Are the febrile temperatures high enough to kill 18:46 syphilis and gonorrhea outright? 18:48 It's a good question. 18:50 For gonorrhea, the answer could be yes. 18:53 Gonococci are very sensitive to temperature elevations 18:56 and they're killed outright at temperatures 18:58 of 41 to about 40 to 41 degrees Celsius. 19:02 However, the direct effect of higher temperatures 19:05 is unlikely to be the mechanism for killing syphilis 19:09 because the amount of syphilitic spirochetes causing 19:12 Neurosyphilis are only killed at temperatures over 19:15 41 degrees Celsius. 19:17 But the temperatures caused by malaria 19:21 very seldom reach 41 degrees Celsius. 19:23 So the beneficial effect of the malarial fevers 19:25 in the case of syphilis would not have related 19:28 to the direct effect of the fever on the syphilis. 19:33 It would have to be related to a different mechanism, 19:35 that is the fever's ability to stimulate or turn 19:39 on the immune system to start working. 19:42 And this is the most important mechanism by which 19:43 fevers help fight infections, we're gonna see shortly that 19:47 fevers can stimulate or turn on the host 19:49 defense mechanisms, resulting in increased 19:52 antibody production leukocytes, phagocytosis 19:55 and other mechanisms. 19:56 Thus fevers help the body fight bacteria such as 20:00 syphilitic spirochetes and gonococci. 20:03 Other question is, can fevers help fight viruses? 20:08 Well, we find that febrile temperatures have 20:10 a direct inhibitory effect on most viruses. 20:13 Poliovirus is inhabited by febrile temperatures. 20:18 Poliovirus grown at higher temperatures 20:20 at a 104 degrees Fahrenheit were 250 times smaller 20:25 than those grown at lower temperatures, 20:27 say 98.6 degrees Fahrenheit. 20:31 These viruses were not destroyed by the heat 20:33 but the development was impaired. 20:37 Febrile temperatures directly kill or inhabit 20:40 some viruses and bacteria. 20:42 However the fevers most powerful means 20:45 of killing viruses and bacteria 20:46 is through the stimulating immune system. 20:48 So let's take a few moments and let's look at how 20:51 the T-cells and the white cells 20:55 are stimulated by a fever. 21:00 When an infection occurs, the fevers work to enhance 21:04 T lymphocyte activation and proliferation, 21:08 these cells are important in fighting viruses and tumors. 21:15 Studies by Gordon Duff, Scott Durum at Yale 21:18 show that T-cell production rate increases 21:21 as much as 20 times when the temperature elevates 21:24 from 98.6 to 102. 21:27 Massive increase in production of T-cells 21:31 also lymphocytes are activated to fight viruses 21:33 more readily at these higher temperatures. 21:38 Interferons these are proteins which exert 21:40 antiviral and antitumor, antibacterial actions, 21:43 very important in fighting tumors and bacteria. 21:47 When the temperature is raised from 21:49 102 to 104 the Interferon becomes more than three times 21:53 as effective in fighting a virus in a tissue culture. 21:57 Febrile temperatures dramatically increase 21:59 interferon production which is stimulated 22:02 by the presence of a virus. 22:04 Interferon itself appears to be generated, 22:07 to generate fevers through the production of Interleukin 1. 22:16 What we find is that white cells 22:18 can engulf bacteria and this is called Phagocytosis. 22:25 The Phagocytic activity increases 22:27 at higher temperatures in some studies. 22:30 White cells, which do the phagocytosis 22:33 are eating the bacteria, their white cell mobility 22:37 also increases markedly between 22:38 35 and 40 degrees Celsius. 22:41 Some bacteria are killed more efficiently 22:43 once they're ingested by the white cells 22:45 at these higher temperatures. 22:47 Many bacteria need iron to grow and live, 22:51 and at higher temperatures bacteria's centrifuge system, 22:55 which helps transport iron into the bacteria 22:57 is compromised, so they can't bring 22:59 that needed iron into the bacteria for survival. 23:02 Also during fevers, white cells release substances 23:05 to bind free serum iron and to lower its concentration 23:09 thus making it unavailable to bacteria. 23:12 So fevers actually act to help starve bacteria 23:17 from the iron that they so desperately need. 23:22 In chronic inflammatory diseases, 23:24 anemia with low iron count is common, 23:28 and is due in part to this effect. 23:31 Desert iguanas use this effect to help 23:33 survive an infection with A hydrophila. 23:38 In those cases there is a drop in their serum iron 23:42 by as much as 30%, why would this be helpful, 23:45 well it was found that the A hydrophila bacteria 23:48 infecting the lizard has enough iron to eat 23:52 when it's in culture media, when there is enough iron 23:56 in the culture media. 23:57 Its growth is not slowed by increasing 24:01 the temperature from 38 to 41 degrees centigrade, 24:04 oh Celsius, excuse me. 24:05 However, if the iron in the media is decreased 24:09 the bacteria growth rate is markedly slowed 24:12 by raising the temperature from 24:13 38 to 41 degrees Celsius. 24:16 Thus the lower iron concentrations 24:19 with the higher temperature work together 24:22 to starve the hydrophila of the iron and help kill it. 24:26 Similar results were found in rabbits infected 24:28 with bacteria as well, so fevers are helpful 24:32 in bacteria and viral infections, 24:34 but are they helpful in cancers. 24:36 Fever therapy has some success as an anti-tumor agent 24:40 according to articles by Cavaliere in 1967, 24:46 by Suit in 1974, by Overgaard in 1977, 24:49 and for over a 100 years there has been a length 24:51 between high temperatures and tumor aggression, 24:53 that's been noted in the medical literature. 24:57 In 1893, William Coley started treating cancers 25:00 by infecting patients with bacteria, 25:02 a streptococcus species often mixed 25:04 with other species of bacteria. 25:06 He had some success with this form of cancer therapy, 25:08 either from the fevers themselves 25:10 or some other effect of the bacteria on the immune system. 25:14 In what way did these febrile temperatures work 25:17 to fight cancers? 25:18 Well, high temperatures have a direct anti-tumor effect 25:21 on many types of tumor cells, various malignant cells 25:25 when heated to 41 to 43 degrees Celsius 25:28 appear to be selectively destroyed by heat. 25:31 Several mechanisms have been found, 25:33 high temperatures do inhibit the cellular activities 25:36 found in the RNA and the DNA, 25:38 but this is not restricted just to tumor cells. 25:41 High temperatures markedly depress various 25:43 metabolic and respiratory processes of tumors, 25:46 but not healthy cells. 25:48 And that is more selective toward cancer cells. 25:51 Lysosomes are intercellular sacs containing 25:55 toxic chemicals, heat increases the number 25:57 of these lysosomes in the tumor cells 25:59 and these tumor cell lysosomes are more sensitive to heat 26:02 than those in the healthy cells release their 26:05 destructive enzymes more easily, calling, causing 26:07 the tumor cell destruction that contains them. 26:11 This process can defend against intercellular viruses. 26:16 However, I believe the most important role 26:17 of febrile temperatures in cancers is to, 26:19 is its ability to stimulate 26:20 immune system as noted earlier. 26:23 Let me ask if hyperthermia is being used today? 26:25 Yes, it is. Duke University, Dr. Dewhirst is using it 26:29 to heat up tumors locally, they apply microwaves 26:32 to an area before applying or giving chemotherapy 26:36 and this does improve the survival rate 26:40 at Charite Hospital in Berlin, Germany. 26:45 Dr. Whirst is using it to treat tumors locally, 26:49 they use local hyperthermia, heat up the tumor locally 26:52 and again this is used with chemotherapy 26:54 and it does improve survival. 26:57 In China it is been shown to double survival, 26:59 they are using it to heat tumors locally 27:02 and again in conjunction with chemotherapy, 27:05 they're using for pancreatic cancers, 27:06 head and neck cancers, 27:08 and non-small-cell carcinoma of the lungs. 27:14 It's also being used at 27:17 University of Texas at Houston, 27:19 they don't use local hyperthermia but whole 27:21 body hyperthermia under anesthesia, 27:24 and they apply chemotherapy and this improves their 27:27 success rate as well. 27:28 At Eden Valley, we use a whole body 27:31 hyperthermia and a water tank, 27:34 we use it with minimal expense, 27:37 these are simple remedies that can be used at home, 27:40 body temperature is raised. 27:42 And we've also been able to give intravenous Vitamin C 27:45 with this as well as nutritional supplements 27:47 to help the body fight the cancers, 27:51 strengthen the immune system and stimulate it to action. 27:56 We hope that you can remember the benefits of fever 28:01 in fighting local infections and again, 28:04 consider allowing temperatures to run, 28:06 keeping children comfortable 28:08 when they have fevers. Thank you. |
Revised 2014-12-17