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Pain - Case study - midnight house call - urinary tract pain

by Paul Bergner

Medical Herbalism 10-31-94 6(3): 8-9

This is a case of making do with what’s on hand. I got a call from a friend at 12:30 AM that she had a severe urinary tract infection and had been in excruciating pain for 3-4 hours. She had had the condition and the same symptoms before. She was drinking large amounts of water which was not helping. The pain was constant, but worse at the end of urination. She described the pain as stinging or burning. She said that one time in the past a single cup of comfrey tea had quickly resolved the pain.

The patient was a single mother with a high-stress managerial job, with new financial problems and also a new live-in lover relationship for the past month. She had a history of childhood physical abuse (torture) and sexual abuse. The condition did not appear to be “honeymoon cystitis” because it was not immediately following intercourse, but had been building gradually for a few days, and matched previous symptoms from before the relationship. She had recently started drinking coffee again after stopping for 3-4 months. She thinks this is what has triggered her cystitis.

The “doctor-patient” relationship was strong, and we had found the “placebo” effect very powerful in the past. I had to make do in this case with the limited herbs and other remedies I had in a first aid kit.

Sig:1 tsp Echinacea tincture (to mobilize immune response for possible infection.)

1 tbsp Althea off. tincture (Marshmallow root) in 1/4 cup warm water. This was the closest thing I had on hand to comfrey root, which, given her experience in the past, would have been the “perfect” herb.

1200C Apis mellifica (homeopathic). [would have preferred mother tincture or 6C, but this was the only thing on hand. The keynote symptom was burning at end of urination.

Response: There was no immediate amelioration or exacerbation of the condition. The patient remained in extreme mental distress and agitation. After 15 minutes, she was still in too much pain to sleep, refused hydrotherapy treatments (sitz bath), and demanded further treatment.

Formula: Post Surgical Pain formula

Equal parts Valeriana off. (valerian), Humulus lupulus (hops), Hypericum perforatum (St Johnswort), Salix alba (willow bark), and one-hall part each Arnica montana (toxic) and Delphinium staphysagria (toxic).
 
Copyright 2001 Paul Bergner    332

 

    Medical Herbalism: Clinical Articles and Case Studies    

Sig:10 drops in 1/4 cup warm water.

This formula was designed for use following minor surgery. The strategy here was to support the healing power of sleep, and accept the likelihood of antidoting the homeopathic remedy. To maximize the placebo effect I to told her how it was a very powerful, potentially toxic (in high doses) formula, and in front of her I dramatically counted out precisely ten drops with a grave expression.

Response: 3 minutes: an aggravation — stabbing pains. passed quickly.

5 minutes: getting sleepy

10 minutes: went to sleep. Got up three times in the night to urinate (had drunk a lot of water) with mild but not marked pain. Woke in morning: pain completely gone.

Follow up recommendations:

Medical exam to rule out new sexually transmitted disease

Keep drinking plentiful water

Low dose daily echinacea (30 drops three times a day.)

Marshmallow tea for three days.

Urinary tract strengthening herbs. A proprietary German “Kneipp” tea containing goldenrod and uva ursi.

Cranberry juice as preventive

Examine coffee issues and consider quitting again.

Note: symptom picture returned in eight days, but less severe.

Comments: I had no access to regular pharmacy, and only brought along limited pharmacy in a first aid kit. The immediate therapeutic goal, to induce sleep and give relief of pain, was successful. The suppressive nature of the treatment is demonstrated by the recurrence eight days later. She ultimately gave up the coffee, ended the new love relationship, and did not have a recurrence in the year following. Clinically, this case was very sloppy, but it is difficult to be ideologically correct in the face of severe pain.
 
Copyright 2001 Paul Bergner    333