PHYTOTHERAPY ANATOMICAL CLASSIFICATION Urogenital 1. Genital disorders in females 2. Genital disorders in males 3. Other disorders relating to genital apparatus 4. Urologics Also: ImpotenceeFibroadenosis Vaginal candidiasis Genital herpetic infection Kidney stones Prostatatis Cystitis Nephritis/nephrosis Incontinence Pyelitis - Genital disorders in females --- Rem. in vaginitis, vulvitis etc.3 Ext.: The most vulneraries (SEE Skin): Alchemilla. Bryonia. Cimicifuga. Lactobacteria. Myrica. Tabebuia (int.). --- Rem. in salpingitis Serenoa. --- Rem. in cervicitis Angelica sinens. Calendula (ext.). Caulophyllum. Echinacea (ext.). --- Rem. in metritis, endometritis, ovaritis Baptisia. Caulophyllum. Echinacea. --- Rem. in endometrios Angelica sinensis. --- Rem. in myomata Caulophyllum. Vitex. --- Obstetric remedies ----- Rem. in agalactia Anemone puls. Galega. Foeniculum. Medicago. Urtica. Verbena. Vitex. ----- Rem. in galactorrhea Alisma. Salvia. ----- Rem. in prolaps Caulophyllum. ----- Rem. in postnatal disorders Crocus. Vitex. ----- Rem. in mastit Baptisia. Bryonia. Melilotus. Phytolacca. ----- Rem. in mastalgia Oenothera. --- Rem. in menstrual problems ----- Dysmenorrhea Achillea (w). Alchemilla (w). Angelica sinensis. Artemisia vulg. Caulophyllum. Cimicifuga. Commiphora m-m. Crocus (w). Ferula a-f (w). Gelsemium. Helianthus (w). Leonurus. Matricaria. Melissa. Nepeta (w). Nuphar. Paeonia. Potentilla anser. Scutellaria. Serenoa. Turnera (w). Viburnum. ----- Hypermenorrhea Actaea. (Alchemilla). Artemisia vulg. ----- Polymenorrhea Alchemilla. Crocus. Nuphar. ----- Amenorrhea Artemisia vulg. Caulophyllum. Commiphora m-m. Crocus. Ferula a-f. Leonurus. Nepeta. Petroselinum. Ruta. Tanacetum vulg. Verbena. ----- Climacterial disorders Anemone. Angelica sinensis. Cimicifuga. Equisetum. Leonurus. Nuphar. Ruta. Trifolium prat. Verbena. Vitamin B6. Vitex. ----- PMS Angelica sinens. Leonurus. Magnesium. Oenothera. Petroselinum. Populus trem. Vitamin B6. (Vitex). ----- Miscariage-to prevent Viburnum. Vitex. ----- False labour under pregnancy Cimicifuga. Viburnum. ----- Braxton-Hicks contractions, Mittelschmerz --- Other remedies ----- Uterodynia Artemisia vulg. Caulophyllum. Nuphar. Scutellaria. Viburnum. ----- Uterus atony Actaea. ----- Ovaralgia Actaea. Anemone. Caulophyllum. (Serenoa?). ----- Hyperprolactinemia Vitex. ----- Leucorrhea Ext.: The most vulneraries (SEE Skin): Caulophyllum (int.) and Lactobacteria (ext.). ----- Osteoporosis Equisetum. Medicago. Trigonella. ----- Fibroadenosis2 - Herpetic infections4 - Genital disorders in males --- Rem. in orchitis, epididymitis Anemone. Angelica sinens. Bryonia. Cimicifuga. Phytolacca. Serenoa. --- Rem. in orchialgia Anemone. Caulophyllum. --- Rem. in testicle atrophy Serenoa. --- Rem. in prostatitis6 Arctostaphyllos. Cimicifuga. Cucurbita (prevent.). Elytrigia. Equisetum. Juniperus. Serenoa. --- Rem. in prostatorrhea, spermatorrhea Anemone. Nuphar. --- Rem. in prostatectomy (before and after) Populus tremula. --- Rem. in BPH Cucurbita. Populus trem. Serenoa. Urtica. - Other disorders relating to genital apparatus --- Rem. with oxytocic effects Anemone. Leonurus. --- Rem. in infertility Angelica sinens. Crocus. Vitex. --- Aphrodisiac1 Aspidosperma (yohimbine). Ferula a-f. Ledum. Panax ginseng (weak). Turnera (w). --- Anaphrodisiac Cinnamomum camphora. (Humulus?). - Urologics - Remedies in chyluria Alisma. Sepia. Thymus. - Urologics5 ↓ Cysthorrhea: 1st: Arctostaphyllos. Commiphora. Elytrigia. Juniperus. Cystitis, urethritis:7 1st: Althaea. Arctostaphyllos. Elytrigia. Galium. Juniperus. Malva. Populus tremula. Pyrola, Nephritis:8 1st: Althaea. Arctostaphyllos. Commiphora. Elytrigia. Equisetum. Juniperus. Pyrola. Solidago. Pyelitis:10 1st: Arctostaphyllos. Elytrigia. Pyrola. Solidago. Polyuri: 1st: Salvia. Phosphaturia: 1st: Elytrigia. Medicago. Lithiasis: 1st: Althaea. Arctium. Arctostaphyllos. Malva. Glycosuria: 1st: Pyrola. Incontinence:9 1st: Anemone pulsatilla. Equisetum. Verbascum. Althaea In general in cysthitis, urethritis; esp. acute dysuria and lithiasis – as an emollient and tonic. Arctium Alterative. In most urinary inflammations, often in formulas. Mainly emollient and antibacterial. Arctostaphyllos uva-ursi Subchronic states. Relaxed inflamed urethra opening and mucus discharge. Small amounts of urine, polyuria. Betula Urinary disorders associated w. high S-urate, chloride. Cannabis Geriatric: Chronic dysuria, high acidity. In comb. w. Verbascum. Daucus Obvious inflammatory processes w. undefinied charachteristic, often circulatory impairments. Echinacea Toxic albuminuria. Elytrigia Chron. inflammations w. clear renal weakness: dysuria w. spasm and backache from gravel and alkaline, phosphatic urine. Equisetum Acute irritated cyshtitis, urethritis and prostatitis w. inflammation and irritation. Incontinence (often during sleep) in older men. Oedema (nephritic). Galium aparine Acute cysthitis, urethritis w. fewer. Often dysuria and incontinence, also enures in children. Acute disorders, systemic infections. Glechoma Subchronic urinary inflammations w. irritation. Juniperus Chronic. renal weakness whitout inflammation. In prostatitis (swollen prostate), albuminuria; chronic nephritis, cysthitis and cysthorrhea (all with no inflamm.). Juniperus can deteriorate some conditions – low intial dose. Larix Tonic. SEE Arctium Linaria Urotonic, general. Lycopodium Often conditions w. redish urine, often fever, irritation and inflammation. Nuphar Urotonic, general; normalizes all functions. Populus balsamifera Urinary disorders parallelly w. common colds. Populus tremula Pain in kidney tract; frequent small amounts of urine. Pyrola Scanty urine. Often albuminuria (subacute and renal). Chronic pyelithis is the best indication; a tonic for the whole urinary apparatus. Rosa cannina With ascorbic acid to prevent urinary infections in women (reoccuring). Salix As Populus tremula but also with inflamed urethral opening. Solidago Deep seated pain; chronic pyelithis as a result of gravel (even after removed), also inflammation w. pain (deep seated) and discharge. Sorbus Alchyria. Turnea Obvious weakness in urinary and genital apparatus. Verbascum Emollient: SEE also Cannabis 1 Impotence Examination: Anatomic impotency , atonic impotency (resulting from paralysis of nervi erigentes, which convey impulses bringing about erection); functional impotency (due to an organic or anatomical defect); organic impotency (anatomic); psychic impotency (due to mental disturbance); or symptomatic impotency (due to poor health, drugs, or presence of disease). Therapy: - L-Arginine increases the male sperm count. Vitamin E, 400-1,000 IU p. d. (increase slowly). Zinc, 80 mg. p. d. is important in prostate gland function and reproductive organ growth. Vitamin C, 3,000-6,000 mg. p. d. keeps the sperm from clumping and makes the sperm more motileale. - Sabal: Improve prostate health (combined with echinacea). - Damiana: In psychogenic deficiency. - Yohimbine is indicated as a sympatholytic and mydriatic. Impotence has been successfully treated with yohimbine in male patients with vascular or diabetic origins and psychogenic origins (18 mg/day). Yohimbine penetrates the CNS and produces a complex pattern of responses in lower doses than required to produce peripheral (alpha) adrenergic blockage. Common side effects include dizziness, headache, and skin flushing. Not to be used in depressive states or anxiety disorders. - Ledum has effects similar to yohimbine. - Viagra, Cialis and similar prescription in typical erectil dysfunction. - Psychotherapy and sexual therapy can also be used. 2 Fibroadenosis Antiestrogenic, antiprolactinic measurements Check Selenium levels (often to low) Check Iodine levels (thyroidea hypofunction) Obstipation Antistress measurements Recommendations: – Less fat in diet – No coffea or tea (included coffeine free preparations, contains methylxanthins) – No smoking – Lactobacteria supplements – GLA supplement – Vitamin B6 supplement – Vitamin E supplement – Fucus in iodine deficiancy – Hepatoprotectives: Taraxacum. Rumex cripsus – Immunostimulants: Arctium lappa. – Lymphatic regulator: Phytolacca. – – – – – 3 Vaginal candidiasis Use of estrogens, corticosteroids, spermicids or antibiotics? Diabetes, pregnancy increase glycogenic levels in vagina Soaps, hypersensitivity Sexual activities Immunodeficiancy Clamydia infection Thyroidea hypofunction Mental health (stress, depression etc.) Recommendations: – Echinacea tinct. 3 times a day (40-100 drp) – Tabebuia in chronic disease – Alchemilla, infusion as vaginal douch twice a day – Cleansing and detoxification: Rumex crispus. Galium aparine. Phytolacca. Arctium. – Nervines and symtomatics – External ointments: Calendula. Alchemilla. Matricaria. Commiphora. Thymus. – Soaking the tampon with tinct. (calendula 20 ml, thymus 20 ml, alchemilla 10 ml, thyme oil 5 drp) – No sexual intercourse in the period of symtoms. – Avoid cold and humid climate. – Hydrotherapy: Sea salt baths. – Avoid: Mushrooms. Sugar. Cheese. Alcohol. Soya sauce. Dried fruits. Yeast (Brewer's) or yeast extracts and bread. – – – – – – – – 4 Genital herpes infection GHI in women: Exclude possible endometric cancer. Preventive measurements: Condom use and sexual absence (incl. oral sex) during symtoms. – Supplement of l-lysin, 1 g daily – No arginine! – Lesser alcohol, coffea and fat – Hydrotherapy: Bath 35-40º, depend how much that feels pleasant for the pat. gradually add more hot water, note: that it is important that the pat. feels comfortable the whole time. Add pine oil to the bath or lavender oil or 1 liter of strong tea (Thea sinensis). – Externally: To dry out Echinacea tincture. To protect Calendula ointments etc. Macerated oil from Hypericum is a excellent remedy as the volatile oil of Melissa (diluted, direct on the affected areas). – 5 Internally: Echinacea and Garlic capsules to enhance the immunosystem. Cleansing and detoxification by Arctium, Taraxacum, Urtica, Rumex cripsus, Galium aparine, Phytolacca. RENAL CALCULUS (Kidney stones) Surgery treatment indications: – Calculus does not pass after a reasonable period of time and causes constant pain – Calculus is to large to pass on its own – Blocks the urine flow – Causes ongoing UTI – Damages the kidney tissues or causes hematuria – Has grown larger (x-ray) Actions: ESWL. Percut. nephrolithotomy. Ureteroscopic stone removal. Considerations: – Pat. living in a soft water area? – Complications: Renal failure if unrelieved obstruction for > 7 days. – Calcium oxalate supersaturation diseases: [Hypercalciuria and hyperoxaluria] Hyperpara-thyroidism. Renal tubular acidosis. Sarcoidosis. Vitamin D intoxication. Idiopathic hyper-calciuria. – Uric acid stones: [Calcium phosphate supersaturation] Low urine pH (hereditary). Bowel diseases. From alkali, drugs. Renal tubular acidosis. – Other: UTI (cellular debris), especially bacterial infections (more alkaline urine). Insufficient physical activity. Use of stereoids. Profuse sweating, low fluid intake (dehydration). Non-surgical treatment: – Acute: Opium tincture or morphine chloride, in cases of nausea, scopolamine bromide. Ammi visnaga is also efficiant. Mentha piperita as spirit, often for nausea. – Althaea or Malva: Demulcent. – Arctium: Mildly diuretic and demulcent. – Uvae ursii folium: Considered antilithic besides being diuretic. – Solidago: In formulas for its diuretic effect and antilithic. – Elytrigia: Diuretic, demulcent in formulas. – Betula: In hyperuricemia. – Also use of spasmolytics: Ammi visnaga. Viburnum. – Citric acid: In calcium phosphate stones. – Magnesium carbonate or calcium phosphate in uric acid stones (with raw vegetables). – Vitamin B6 and folic acid in calcium oxalate stones together with magnesium carbonate. – Urtica: Diuretic, urotonic, antilithic. Diet: – Drinking a lot of water. – Uric acid stone: Considered food containing purins. No citrus fruits. – Calcium oxalate stone: Avoidance of rhubarb, spinach, beet, Petroselinum and Rumex ssp. (contains oxalates). Dairy products. – Calcium phosphate stone: Avoidance of dairy products. Ref.: NIH Consens Statement Online ”Prevention and Treatment of Kidney Stones” 1988 Mar 28-30;7(1):1-23 6 PROSTATITIS The types: 1. Acute bacterial prostatitis: An inflammation of the prostate gland caused by bacteria such as Escherichia coli and Klebsiella. Severe complications may develop if not promptly treated. Can be fatal if the bacterial infection is untreated (sepsis). 2. Chronic bacterial prostatitis: A recurrent infection and inflammation of the prostate and urinary tract. Symptoms are less severe than those associated with acute bacterial prostatitis. Increasing numbers of men are being diagnosed with interstitial cystitis who had been previously mis-diagnosed with chronic prostatitis. 3. Prostatodynia: Sometimes called chronic pelvic pain syndrome (CPPS), is the occurrence of prostatitis symptoms, without inflammation or bacterial infection. Diagnosis must be: – Digital rectal exam (not in suspected acute bacterial infection) – – Urinary tests to determine leucocytes Prostatodynia is diagnosed after eliminating other probable causes (e.g., kidney stones, interstitial cystitis, urethral cancer). Risk factors: Must been analyzed. – Bladder outlet obstruction (e.g., stone, tumor, BPH), diabetes mellitus, a suppressed immune system, and urethral catheterization; sexually transmitted diseases (e.g., nongonnococcal urethritis, gonorrhea). – Have the pat. unprotected vaginal or anal intercourse? Treatment: Conventional: – Acute bacterial prostatitis is treated with antibiotics such as flouroquinolones and trimethoprimsulfamethoxazole administered intravenously, followed by a course of oral antibiotics (e.g doxycyclin). – Treating the underlying cause (e.g., stones). Complementary: 1. Dietary: Whole, fresh, unrefined, and unprocessed foods. Fruits, vegetables, whole grains, soy, beans, seeds, nuts, olive oil, and cold-water fish (salmon, tuna, sardines, halibut, and mackerel). Avoidance of sugar, dairy products, refined foods, fried foods, junk foods, and coffea/tea. Eliminate food sensitivities. Pat. should drink 2-3 liter of water daily. 2. Nutrients: Bromelain: 400 mg x 3 away from meals. Have anti-inflammatory properties and can potentize the effectiveness of antibiotics. Vitamin C - Take 500-1000 mg x 3. Vitamin E - Take 400 IU daily. Flaxseed 2-4 tbsp daily to breakfast. Lactobacillus, emulsion, in beverage or capsules – ad lib. Zinc: 30 mg daily. Vital to the health of the prostate, which concentrates and secretes zinc. Also prevents infections. 3. Phytopharmaceuticals: Arctostaphylos uva ursi: Urinary antiseptic with diuretic properties, mainly in subchronic or chronic states. Elytrigia: Very valuable for treating enlarged and infected prostates. It has a soothing effect on the genitourinary system. Works as a diuretic and also has demulcent and anti-microbial properties. May be combined with Serenoa serrulata or Echinacea. Echinacea: Uses as an antibiotic and immune system stimulant. Has anti-bacterial, anti-viral and antimicrobial properties that work well on the reproductive system. Combines well with Serenoa serrulata for treating prostatitis. May be combined in equal parts with Serenoa and used as a suppository (inserted rectally after each bowel movement) for prostatitis and enlarged prostates. For acute conditions take 1 tbsp T. every hour or two. Allium sativum: Has tonic, stimulant, hypotensive, spasmolytic and anti-microbial properties. Purported to help treat infections and combines well with Echinacea and Hydrastis for treating microbial activity. Hydrastis: Tonic, astringent and antiseptic properties. The astringent and tonic properties are useful in treating and strengthening reproductive organs. Combines well with Serenoa serrulata and Echinacea for prostatitis. Used in breef periods. Not been used in: High blood pressure, heart disease, diabetes, glaucoma or stroke. Juniperus: Good for genito-urinary infections (but not inflammations) and incontinence. Diuretic. Not been used in: High blood pressure. Caution in kidney problems and diabetes. Althaea: Demulcent, diuretic, tonic and emollient properties. Help soothe and protect the genito-urinary system. One study has shown that Althaea enhanced white blood cells ability to devour microbes. Caution: In diabetes. Pyrola: Has diuretic, tonic and astringent properties. Used mostly for genito-urinary system. Purported to be very effective for chronic prostatitis and other genito-urinary disorders. Has a gentle yet powerful soothing effect. Decoctions are to be prefered. Serenoa serrulata: Diuretic and urinary antiseptic properties. Very effective for genito-urinary system. Studies have shown that Serenoa can increase urine flow by 38% for prostatitis and BPH, while helping to treat infection. Helps tone the bladder, thereby helping to relieve straining pains. Combines well with Echinacea for prostatitis treatment. May also be used in suppository form. 4. Cucurbita pepo: Natural source of Zinc and linoleic acid (LA). Important in helping to decongest the prostate gland and lessen residual urine. Also with diuretic properties. Angelica sinensis: Has spasmolytic and diuretic properties and has been useful in treating prostatitis. Works well with Viburnum for genito-urinary spasm. Caution: Not in diabetes. Matricaria recutita: Spasmolytic, antiseptic, anti-inflammatory, and analgesic properties. It is used as a mild sedative and works well for adults, children and the elderly. Calming effects on cramps or painful symptoms of the genito-urinary system. Combines well with Valeriana and Althaea. Pycnogenol® (Extract from the bark of Pinus maritima ssp. atlantica): Contains proantho-cyanidins and are a powerful antioxidant. Can be given 200-300 mg daily in 3 doses to protect tissues in chronic diseases. Quercetin: Is of great use in CPPS, use also bromelain together. About 200 mg x 2 of quercetin and standard doses of bromelain. Caution: Do not combine this with quinolone antibiotics (eg Trovan®, Cipro®, Levaquin®, Noroxin®, Floxin®) may make they less effective. Quercetin can also be used in chronic prostatitis combined with an antibiotic substance (Allium sativum). Hydrotherapy: All kinds of warm bath is valuable reliving the symptoms of prostatodynia and nonbacterial prostatitis. References: - Capodice JL et al. Complementary and alternative medicine for chronic prostatitis/chronic pelvic pain syndrome. Evid Based Complement Alternat Med. 2005 Dec;2(4):495-501 - Dhar NB, Shoskes DA. New therapies in chronic prostatitis Curr Urol Rep. 2007 Jul;8(4):313-8 - Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial Urology. 1999 Dec;54(6):960-3 - Cai T et al. Serenoa repens associated with Urtica dioica (ProstaMEV) and curcumin and quercitin (FlogMEV) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomised study Int J Antimicrob Agents. 2009 Jun;33(6):549-53 7 CYSTITIS (Inflammation of the bladder) Etiology: – Sex: Women are more prone to cystitis than men because the tube (urethra) that runs from the bladder to the outside of the body is much shorter (about 5cm/2ins) in women than it is in men (about 18cm/7ins). This means that bacteria can more easily travel to a woman's bladder than it can a man's. What's more, the opening to the urethra is close to both the anus and the vagina in women, which provides even easier access for bacteria to enter the urethra and to make its way up to the bladder. – Pregnancy: Pregnant women may be more susceptible to infection because of hormonal change resulting in dilation and reduction in tone of the ureters. Pressure of the uterus on the bladder and local venous congestion and pressure may also be factors in precipitating cystitis in pregnancy. – Diabetes: Diabetics and those with high consumption of sugars are predisposed to cystitis. – Chemical factors: Antibacterial soaps, sprays, douches, feminine deodorants, contraceptive jellies and creams alter the vaginal environment and may cause irritation that makes the tissue susceptible to infection. In addition, barrier contraceptive devices like the diaphragm may cause mechanical irritation of the urethra. Some forms of interstitial cystitis may be caused by food contaminated with pesticides. – Urine retention: Anatomical deviations, such as uterine malpositions, that result in retention of urine potentiate infection. – Hormonal changes: Oral contraceptives may initiate infection in some individuals. – Antibiotics: Overuse of these potentially life-saving drugs will select for resistant bacteria, often leading to cystitis. – Stress: Results in the production of hormones such as ACTH, glucocorticoids and aldosterone, all of which reduce circulating white blood cell counts and contribute to the susceptibility for infection. Many who experience recurrent infection can relate stress (chemical, physical, emotional) to the onset of symptoms. Symtoms: – Most common: Polyuria. Dysuria. – Dragging pains in the lower abdomen and back. – Nausea and vomiting. Urethralgia. Dark, often foul-smelling urine (pyuria), sometimes hematuria. Fever, if there is an infection present. These symptoms must be distinguished from those caused by vaginitis, sexually transmitted diseases and irritations of the urethra. Problems with diagnosis: – Many women have bacteriuria, and pyuria in the absence of symptoms, whilst others experience symptoms without clinical signs. Women with no clinical sign of cystitis who complained of recurrent symptoms were diagnosed as having urethral syndrome in the past. – Urologists have recognized a variety of cystitis, interstitial cystitis, comprising a group of urethral/bladder disorders in which the mucosa of the bladder has become eroded resulting in ongoing symptoms in the absence of bacteriuria. Treatment: – Conventional treatment: Urinary antiseptics and antibiotics. Chemotherapy itself is a cause for ongoing infections. – Complementary treatment: The diagnose decides the treatment, If its necassary with a conventional antibiotic. 1. Hygien: Its of great importance for women to maintain a rigourous hygien, especially in periods of menstruation. 2. Anti-microbials: Terpene essential oils (e.g Juniperus) are indicated here as the oil is excreted from the body via the kidney, thus directing to the site of infection in the bladder. Many of them should not been used where there is an obvious inflammation or in kidney insufficiency. 3. Anti-inflammatories: Will soothe the pain and discomfort. Avoid overemphasizing them in the prescription. The symptomatic relief they produce must be applied in the context of removing the infection that causes the inflammation. 4. Astringents: If there is hematuria. 5. Diuretics: Helps flush the whole of the tract. Of course it is best to select diuretics that possess the actions mentioned above. 6. Spasmolytics: May be necessary if there is much pain. 7. System Support Remedies (SYSR): The specifics will depend upon careful diagnosis. If the cystitis is clearly associated with the following conditions, use the tonics suggested: - Pregnancy: Uterine tonics. - Hormonal changes (menopausal or due to the contraceptive pill) : Vitex plus appropriate uterine tonics. - Diabetes: Endocrine support with amara. - Immune system weakness: Both deep and surface immune support. - Stress: Adaptogens, nervines. 8. Nutritives: - Vitamin C: Is important in all cases of infection, and it also helps to boost immune activity. Many studies have shown that vitamin C helps to increase immune function. In the case of cystitis, vitamin C has been shown particularly to inhibit the growth of E. coli. Ascorbic acid will be too acidic for cystitis sufferers. Vitamin C at 500mg four times per day when the cystitis is present (use the calcium or magnesium ascorbate forms). - β-carotene (precursor to vitamin A): Help to maintain healthy cells. By keeping cells healthy, you are more likely to prevent an invasion by bacteria. Vitamin A is also important for a healthy immune system. β-carotene 25,000 IU daily. - Zinc: An important mineral for the immune system and it needs to be given both when an infection is present and to prevent a recurrence. It is recognised for it anti-infectious properties - Bromelain: Digestive enzyme that is known for its anti-inflammatory properties, and it has been shown to have a beneficial effect on urinary tract infections, including cystitis. Dose 500mg x 3 between meals. - Lactobacillus acidophilus: Probiotic helps to restore the healthy bacteria flora in the body. In an attack of cystitis it may be beneficial to use a vaginal cream that contains acidophilus as well as giving it orally. Lactobacillus acidophilus is available in a variety of different forms, including tablets and live organic yoghurts. For best effect, incorporate all of these forms into diet under an attack. - Cranberry (juice): If there have been a chronic cystitis in the past, it is worth trying cranberries as a preventative measure. Cranberries (Vaccinium oxycoccus) help in cystitis and can significantly reduce the bacteria associated with urinary tract infections. Cranberries contains substances called catechins that can stop bacteria such as E. coli from sticking to the walls of the urinary tract. To infect the urinary tract, bacteria must first stick to the mucosal walls of the tract. If they are unable to do so, they cannot multiply and are flushed from the body in the diuresis. Treatment fails: In standard treatment with quinolones (cinoxacin, ciprofloxacin etc.): S. saprophyticus?; or E. coli? (quick – – – – resistence); otherwise: – Genital infection (clamydia, condylomata, genital herpes or candida-colpitis). – Other causes (e.g obstructions). Phytopharmaceuticals: The most important drugs 1. Arctostaphyllos uva-ursi: Acute or chronic urinary infections, preferably subchronic states. 2. Apium graveolens: A strong diuretic (urine retention) and urinary antiinflammatory remedy, can however irritate the urinary apparatus in higher doses; emmenagogue! 3. Allium sativum: Antibiotic that can control many bacteria which have been implicated in cystitis such as E coli, proteus, klebsiella and staphylococcus. 4. Echinacea: To prevent further infections causing cystitis, you will need to strengthen the immune system. Echinacea has been shown to increase the white blood cell count and activity in order to effectively engulf bacteria and viruses. The drug appears to be more effective when taken on and off (1 weeks treatment, 1 weeks pause and so on). Caution: In medication with fertillity drugs, HRT or any other hormonal treatment. 5. Althaea: A great demulcent drug that fight inflammation and irritation. Standard remedy in all kinds of urinary discomfort. 6. Elytrigia: Have a soothing effect on the genito-urinary system. Works as a diuretic and also has demulcent and anti-microbial properties. 8 Nephritis and nephrosis Early signs to be aware of: Oedema, anemia and various salt imbalances. Early tests in albuminuria and creatininuria. Etiology: – Nutritional imbalances. – Hepatitis. – Urinary diseases. – Liver and spleen problems. – Heart disease. – Abdominal tumors. – Connective tissue diseases. – Diabetes. Nutrients and diet: 1. Vitamin E supplementation has been shown to slow the progression of nephropathy (Kuemmerle et al 1999). 2. Low protein diets are always prescribed for severe kidney disorders because they lessen the metabolic strain on the kidneys. However, the prescriptions rarely specify the types of protein that should remain in the diet. As a rule, vegetable protein is much easier on the kidneys. 3. Avoidance of low quality fats and oils helps reduce kidney inflammation. By the same token, use of essential fatty acid (EFA) supplements can help with many renal disorders. Phytopharmaceuticals: The most important drugs 1. Urtica dioica: Great remedy in nephritis, diuretic and antiinflammatory. Positive effect on states with elevated homeotoxins. 2. Alisma plantago-aquatica: Antiinflammatory and diuretic, antihypertensive. 3. Astragalus membranaceus: The polysaccharides in Astragalus have been shown to intensify phagocytosis of reticulo-endothelial systems, stimulate pituitary-adrenal cortical activity and restore depleted red blood cell formation in bone marrow. Astragalus is also one of the herbs known to stimulate the bodies natural production of interferon. The therapeutic potential offered is very exciting. The conclusion being drawn by most western herbalist's is that Astragalus is an ideal remedy for anyone who might be immunocompromised in any way. 9 Incontinence Etiology: – Weakened pelvic muscles. – Certain medications. – Build-up of stool in the bowels. – Urinary infections. – Diabetes. – Hypercalcemia. – In women after menopause: Dry mucous membranes (vagina and urethra). In men: Enlarged prostate. Parkinson's disease. Alzheimer's disease. Endogenous depression. Phytopharmaceuticals: The most important drugs 1. Galium aparine: A traditional remedy in incontinence, a typical urotonic. 2. Equisetum: Also a typical urotonic. Astringent and strengthen the connective tissues and help restore the urinary system. The most valuable remedy in incontinence. 3. Althaea: Soothing and demulcent properties. A standard remedy in all kinds of urinary discomfort. 4. Certraria: Natural antiseptic and soothes the tissues. In formulas. 5. Harpagophytum: Antiinflammatory drug that also will strengthen the bladder so it can hold urine until it is possible to empty it. 6. Petroselinum: In nervous tension. 7. Scutellaria: Calms the nerves and thus may be helpful in certain kinds of incontinence. – – – – 10 Pyelitis. Synonyms: Pyelonephritis. Definition: Primarily, an inflammation of the pelvis of the kidney, though the contiguous renal tissue soon becomes involved, with varied results. Etiology: – Foreign bodies, especially from renal calculi. The finer calculi, gravel, or even uric acid sand, may be sufficiently irritating. – The decomposition of retained urine in the pelvis, due to obstruction of the ureter, either from growths or foreign bodies. – Urethritis or cystitis, especially where there is gonorrheal infection. – Kidney cancer. – TBC. – Parasites (rarely): echinococcus, distoma, etc. – Irritating substances, e.g mustard or chili. – Diphtheria. – Scarlet fever. – Small-pox. – Typhoid and typhus fever. – Enlarged prostate. – Phimosis. – Surgical kidney: This is usually bilateral pyelitis, and unilateral when the result of a calculus. Diagnosis, guidelines: – It is sometimes quite difficult, if not impossible, to differentiate suppurative pyelitis from cystitis; the chief points to be remembered are, that in pyelitis the urine is acid and the pain in the lumbar region, while in cystitis the urine is ammoniacal and the pain is in the bladder. – It is also difficult to diagnose pyelonephritis If the patient using analgetics or antiflogistics. Treatment: In acute states there are always a risk for urosepsis. In severe case – hospital, otherwise norfloxacin or similar antibiotics. Dietary guidelines: The diet will consist of sweet milk and plenty of pure water. Phytopharmaceuticals: The most important drugs 1. Mild diuretics: Althaea. Elytrigia. 2. Echinacea, Baptisia in suppurative conditions.