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for next week: there's a case to do and a self assessment quiz, no reading
cystitis video online is same as what he will present today

***************************************************************************
International congress of Homeopathy
in Los Angeles this year
rare to be in US
an ND is speaking at this one so Dr Taylor is not boycotting
used to be all MD's
Dr T presenting on chronic disease
I didn't find him in list of presenters: http://www.liga2010.org/schedule.html
Indian master on snake remedies
end of May
http://www.liga2010.org/
http://www.homeopathyworldcommunity.com/events/65th-congress-of-the-liga
*********************************

Where you find cystitis rubrics
sections: bladder, kidneys prostate, urethra, urine, urinary organs

*urinary organs section in Synthesis exists because structure inherited from Kent
wanted to follow how Vithoulkas thinks
building repertory by adding from Herring, other practitioners
but this didn't include a portion of info from Boenninghausen, different structure
so imported Boenninghausen's section as "urinary organs"
good to combine two traditions: Kent and Boenninghausen

Bladder-inflammation (=cystitis) (129) p1024
(include rubric with over 160 rubrics: makes no difference, does not help)
covers both IC and infx but DrT not use for 2 reasons: too general
can use for elimination, don't use anything not in this rubric, risk in this
he uses eliminative rubrics experimentally (can do this in radar): does it clarify?

Bladder-pain-urination p1027
urination after agg
(character of pain)
before
(character of pain)
delayed
during
(character of pain)
beginning of
end of

Bladder-pain-extending to (this section after the A-Z section) p1028

Bladder-tenesmus
sphincter spasm after or during release, sense of urging, painful

Bladder-urination p1032
dribbling, dysuria (no good), frequent (duh, 293, use urging)
involuntary, retarded, unsatisfactory
urging to urinate (big) and interesting subrubrics

Urethra
discharge
irritation (esp by mechanical or chemical process)
pain-urination (here or bladder, rubrics prob much same)
tenesmus
(bladder pain mb referred from urethra: look in both places)

Urine p1070
bloody
color
mucous
odor (horrible, offensive)
sediment
taste

Kidney
inflam-pelvis
inflam-pelvis and kidneys
pain
pain extending to
stones (see also: urine-sediment-sand, gravel)

Concomitants:
Mind
Chill
Fever
Perspiration
Generals
concomitants anywhere
Female: menstrual complaints

CHILDREN
1st UTI in boys usudt congenital anomaly: refer to urologist
repeat UTI in girls: refer to urologist


************************************************************************************

REGIONAL LEADER
regional leader = strong and guiding sx in context of specific illness
in context of strep throat, regional leader will be drooling and tongue coat
strong sx that open up possibility of a remedy
regional leader for a remedy
for spongia in croup: the cough like saw thru pine board
for sepia in dysmenorrhea: bearing down pains
sim to keynote but not really same thing
keynote is more global

***********************************************************************************

ON ACUTE CYSTITIS
"pain down there" where?
bubble bath, douche, chemical irritation
hygiene: wiping
sex
dehydration
catheter
miasm with mucopurulent disharge: tubercular

4 MAIN categories: intense onset, tenesmus/urging, pain at close, children and others
1) intensity of onset: Cantharis, Mercurius corrisivus (best known of small mercury salts), Aconite (sudden, restless anxiety, urging to urinate, better after 1 dose)
2)tenesmus: apis, nux-v, puls
3)
4)


*****************************************************************************
tOP REMEDIES in his mass repetorization: CANTH, LYC, TeR, ARS, PULS, ACON, SEP, CANNABIS-S, APIS, MED, SAR-S, STAPH, CHAM, NUX-V, MeRC-O-C, UVA, DULC, EQUIS, AURP-PER,, tub, sabal, sigm, santh, tarent, berz-ac, tab, ve?l, bell, methyl, arist-cl
(mostly polychrests)
lyc: does it have bladder or large bowel issues? hard to give
puls: can't wear nylon panties

Cystitis remedies of particular significance:

Remedies with strong "specificity of seat" in urinary tract pathologies:
Sarsaparilla (Sars)
Cantharis vesicatoria (Canth)
Equisetum hyemale (Equis-h)
Petroselinum (Petros)
Doryphora decimlineata (Dor)
Terebinthinae oleum (Ter)
Berberis vulgaris (Berb)

"Big" remedies (polychrests & close):
Aconitum napellus (Acon)
Apis melifera (Apis)
Nux vomica (Nux-v)
Pulsatilla praetensis (Puls)
Staphysagria (Staph)
Sepia (Sep
Lycopodium (Lyc)

"Smallish" remedies of broad application, of particular importance here:
Mercurius corrosivus (Merc-c)
Natrum carbonicum (Nat-c)

************************************************************************************
What you need to know about "cystitis remedies":

Remedies with strong "specificity of seat" in urinary tract pathologies:

SARSPARILLA (SARS)
smilax vine
*indicated in over 50% of all simple cystitis in women
*cutting pain at end/close of urination, passing last few drops
(cutting pain at end central in 95% of cases)
worse sitting, must stand
urine retarded, waiting for it to start
*Standing increases urge and eases passage of urine
(women may stand in the bathtub or shower to pee)
*bad temper, door slamming, offended by every word, ill-tempered, moody
mental/emotional state may resemble Nux vomica
("vexed by even the fly on the wall")
(people who need phosphorus can't stand suggestion of pain like peeing razorblades)

CANTHARIS VESICATORIA (CANTH)
insect remedy-->burning: other insects: apis, coc-c, aphis, vesp, pulx, dor
mentioned most often in UTI's, hugely prescribed as a specific, overused
shows up in lots of generic cystitis rubrics, comes up 2nd to everything
but unlike dros for pertussis, it isn't actually commonly indicated
is much more than a UTI remedy
also big in mind, expectoration, skin, hearing, external throat, sore throat
Spanish fly is actually a beetle
was used for aphrodisiac, causes itching/burning of genitalia
*intense UTIs (compare Merc-c)
*in lots of bladder rubrics - comes up well in incautious repertorizations
*intense burning, as if passing acid, each drop, hurts so bad they get tenesmus
*acrid, excoriating urine, often bloody, may excoriate external genitalia
*may pass burning urine by dribbles & drops
*may pass pure blood
** > immediately after peeing (not so merc corr)
< motion, urging, touch or jar
> cold amel; sits in cool water and pees into tub

NATRUM CARBONICUM (NAT-C)
*cutting/burning pains at the close of urination
*commonly recurrent cystitis, with acute episodes resembling Sarsaparilla
*most commonly in chronic cases calling for Nat-c
confirmatory: loves potatoes Generals-food and drinks-potatoes, desires
potato defense: woman buys potatoes while in acute so can use sx even if it's chronic
silent grief

CANNABIS SATIVAS
it tubercular, Cheech & Chong feel persecuted and want to travel in VW
pain at the close or urination as leading sx
95% sars
4.95% nat c
.05% cannabis: in cases of gonorrhea, chlamydia, "nonspecific" urethritis

EQUISETUM HYMENALE (EQUIS-H
feels OK when bladder is full, urging increased when they pee
may distent as a result
*paradoxical urging - increases as the bladder is emptied

PETROSELINUM (PETROS)
parsley
indwelling catheter, chemical irrit, gonorrhea
usu UTI after instrumentation esp catheter
more in males
*itching in the fossa navicularis, (just inside glans)
as if would feel good to scratch inside
*cystitis/urethritis related to indwelling catheters
ITCH OR IRRIT

DORYPHORA DECIMLINEATA (DOR)
Colorado potato beetle, yellow and black stripes, bug looks like cantharis
eats same family plants as belladonna
expect burning pains
*very small remedy, seldom will repertorize
*cystitis in kids, related to chemical/mechanical irritation
(bubble baths, masturbation)
in small children

TEREBINTHINAE OLEUM (TER)
goes to kidneys, pain may shoot up ureters while peeing
urine smoky colored, smells like violets
*UTIs progress readily to pyelonephritis
*horrible burning & tenesmus

BERBERIS VULGARIS (BERB)
rare in simple cystitis but imp when there are stones
< kidney punch
pains shoot long distance, to legs, scrotum, wherever
reddish sediment, gelatinous sediment, slimy
< before or after
L side kidney, ureter
splints affected side (bry)
*more common with upper urinary tract involvement - Pyelonephritis, renal colic
*stitching pains shooting, darting up/down urinary tract
*< jar, slightest movement; positive kidney punch (compare Bryonia)

"Big" remedies (polychrests & close):

ACONITUM NAPELLUS (ACON)
*severity of onset is the main issue
*sudden severe onset
*restless anxiety - somatic, mental/emotional

APIS MELIFERA (APIS)
*urging & tenesmus is the main issue
*burning & stinging (like canth) BEFORE or at onset of urination
*Tenesmus AFTER emptying bladder
*Urinary retention in newborns
> coolness
< heat

NUX VOMICA (NUX-V)
**when urging & tenesmus is the main issue
*ineffectual efforts - ineffectual urging, ineffectual urination
*don't knee-jerk on the basis of mental/emotional expressions (compare Sarsaparilla)
Mick Jagger's remedy
doesn't feel done, painful retention of urine
before or during urination
> warm, warm bath
urine, hot feeling, highly concentrated
mental: irritable, restless (short sheeted)

PULSATILLA PRAETENSIS (PULS)
*urging & tenesmus is the main issue
*urging begins again shortly after voiding
increasingly painful urging the longer voiding is postponed
*involuntary urination unless concentrates constantly - unable to hold back
sudden strong urges to pee that they cannot restrain
*sharp pains after urinating
mb chilly but hates overheating
< lying on back < walking
< cold, wet weather, getting feet web, catching cold
sharp pains AFTER urination
think of puls when pain is irreg, paroxysmal, or with spurting or urine
may have mucus

STAPHYSAGRIA (STAPH)
for boards: *"honeymoon cystitis"
violation, mortification
*instrumentation of the urethra (compare Petroselinum, Doryphora)
*burning & tenesmus, unsatisfied long after urinating
> lying curled on side
stretching of sphincters: injury to or stretching of urethral meatus
lack of fully informed consent-->mortification at being violated
(episiotomy remedy too)
*unaccustomed sexual activity with sense of violation

Sepia (Sep)
*commonly has recurrent UTIs
*may be complementary to many "cystitis remedies"
*heaviness of bladder, passive bearing down sensation

Lycopodium (Lyc)
*commonly has recurrent UTIs
*may be complementary to many "cystitis remedies"

****"Smallish" remedies of broad application, of particular importance here:*******

MERCURIUS CORROSIVUS (MERC-C) (HgCl2)
for mb 5% of bladder infx
*seriously intense UTIs (compare Cantharis)
*often grossly bloody, mb mucus, during or at end of void
*horrible burning in bladder and urethra, unrelieved by urination
*terrible, continuous urging, as if will never get done
(Merc, merc sol rarely comes up in UTIs, compared to this rather smaller Mercury salt)
all sx more extreme than merc sol
**if merc=s or merc comes up, give merc corr
also good for UC
< night, will call doctor

*************************************************************************************


27 yr/o man
cc: hurts when I pee

Several days now
getting worse the past couple days
feels like I have to go constantly
I'll suddenly have to go really bad, feels like I'll lose it, need to make a run
no accidents, but it feels like I'm close to losing it
& then the weird thing is, it doesn't come right away
just a few drops at first, burning, then finally can relax & pee
burns bad - it'll stop, until I can relax again, maybe stops & starts like that 5-6 times
the last bit is the worst, horrible burning the last quarter teaspoon or so
never feels done - feels like there's some left

[where's the burning?
back in from the tip, maybe the last couple of inches

[and the feeling of some urine left - where's that?
same place

I've been drinking lots of water, and cranberry juice, 5-6 glasses a day
It's worse when I'm sitting - the urgency to go
& the hot tub last night, that really stirred things up

I used to get these, pretty much the same story, back in college
I'd get tested for clap, never confirmed
usually after a lot of sex
Joyce just got back from 2 months on Kilimanjaro, a few days before this all started
she's fine, & I know she's not bringing anything home

using cervical cap for contraception, without spermicide
monogamous, 4yrs
no hx of sexually-transmitted disease in patient or partner
partner without yeast infection or hx of yeast infection

obj -
uncircumcised male, no lesions, no irritation, non-tender
no inguinal nodes
no epididimal tenderness
no urethral discharge
prostate est. 20g, firm, uniform, non-tender

urinalysis -
ph7.6
cloudy on standing, 2+ mucus in sediment
10-15 wbcs/hpf
0 rbcs
2-12 gram-negative rods/hpf on stained smear of sediment

************************

for acute prostatitis: clematis, pareira, sabal chimaphila
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