Medical Herbalism: Clinical Articles and Case Studies    

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Urinary - Recurrent Cystitis

by Cascade Anderson Geller

Medical Herbalism 11(4):1,10-11

This case is reprinted from the proceedings of the 1998 Clinical Case Conference in Boulder, Colorado, sponsored by Medical Herbalism and the Rocky Mountain Center for Botanical Studies. Information on proceedings books or tapes of the conference, which include panel discussions of sixteen case studies, are available at

Client overview: Female, age 38, middle child, single, Registered Nurse with a masters degree in counseling, working as a counselor in private practice, last physical exam in remote past but much contact with physicians due to condition.

Lifestyle Details: Works ten or more hours per day, reads two hours per day, sleeps “not enough,” exercises in a variety of ways including walking, bicycling, x-country skiing, drinks coffee occasionally, smokes marijuana occasionally, vacations seven weeks a year with adventuresome excursions.

Signs and Symptoms: Recurrent bladder infections especially aggravated with sex since 1967 (nine years.) Symptoms include pressure in bladder, frequency and burning with urination, heaviness in legs, achy, chills, sometimes fever, occasional blood in urine and swollen lymph nodes in groin. Frequent swollen ankles and feet, aching joints, hemorrhoids especially with menses, creation of cysts, regular digestive bloating and digestive upset.

Medical History: Tonsillectomy and adenoidectomy at age 10. Breast lump biopsy at age 22. Groin node biopsy at age 26. Sebaceous cyst removal at age 37. Mammogram last year. Broken bones twice in past 15 years. Currently on macrodantin 25 mg. once daily and 50 mg. with each intercourse for cystitis.

Other treatments: Psychic session with a “psychic homeopathic”: Nat Mur 3x tid and some others. Not much help so started on the macrodantin. Now drinking regular cranberry juice, douching with vinegar, and eating a tablespoon of acidophilus daily.

Diet: According to her five-day diet diary, a full dietary array of foods from carrot sticks to Tab and diet Fresca. Plenty of sweets and few grains or vegetables. About 3 glasses of water a day.

My summary: It takes a lot to knock this energetic and vivacious woman down. She is bright, warm, articulate, and ready to try a new tact with health due to a new and exciting love life with a special man. My take is that she is saturated with life and food and in need of toning and building and allowing her own organs to work on cleansing by providing good foods and herbs and water. She is hesitant to make many dietary changes. Really wants to “fix” this bladder problem.
Copyright 2001 Paul Bergner    399


    Medical Herbalism: Clinical Articles and Case Studies


Treatment plan

Keep a squeeze bottle of calendula extract diluted ½ with water by toilet. Wash after urination and definitely after sex.

Graduate from Ocean Spray to an unsweetened cranberry concentrate. Drink 1 cup per day. Also drink acidified water with fresh lemon juice, 1 glass daily.

Support the liver and digestion with bitter greens cooked and in salads: watercress, arugula, dandelion greens, endive, and especially parsley. Use parsley every other day in quantity (dishes like tabouli which she liked.) Also herbs below.

Sitz baths which another advisor had recommended. This was difficult for her to do and she was honestly saying she would not do them on a regular basis. I applauded her honesty.

Avoid soda pop, hot beverages, and sparkling water. Drink three 8 oz glasses of pure water everyday, more if your lips are dry. Does not include the acidified water. Drink a glass of acidified water or plain water first thing on arising.

Always urinate and use calendula bottle immediately following each intercourse.


Tea: each dried, cut/sifted, wildcrafted (w.c) or organic commercial

Galium aparine w.c. (Cleavers)     1 oz             urinary tonic

Solidago virgaurea tops w.c. (goldenrod), 1 oz     urinary tonic

Rubus rugosa leaf (raspberry), 1 oz         pelvic tonic

Arctium lappa root w.c. (burdock), 1 oz         liver and genitourinary tonic

Taraxacum off. leaf w.c. (dandelion) ½ oz            liver and genitourinary tonic

Taraxacum off. root w.c. (dandelion), ½ oz            liver and genitourinary tonic

Turnera aphrodisiaca leaf (damiana),    ½ oz         pelvic, digestive tonic

Arctostaphylos uva ursi w.c. (bearberry), ½ oz.         diuretic, antispasmodic

Echinacea angustifolia root (echinacea ), ¼ oz.        immune tonic

Mentha spicata (spearmint), ¼ oz.     refrigerant, diuretic, flavoring
Copyright 2001 Paul Bergner    400


    Medical Herbalism: Clinical Articles and Case Studies    

Symphytum officinale (comfrey), 1/8 oz. demulcent, corrective

Signature: Mix all the herbs in a tightly sealable jar and shake well. Use 2 heaping teaspoons to 2 cups of water. Simmer covered for 10 minutes and let stand until cool. Drink in 2 doses, preferably before meals.


Ulmus fulva powdered bark (slippery elm). 3 oz.    Signature: In a small saucepan mix 1 tsp-1 tbls slippery elm in 1/4 cup water or pear or cranberry juice to remove all lumps. Add 3/4 cup water or juice and heat gently and simmer stirring constantly for 2 minutes. Cover and let cool. Eat/drink ad lib to relieve irritation.

Tincture: Be sure and take this if you miss your tea.

Mahonia nervosa bark (oregon grape), 5 drams         antiseptic, urinary tonic

Urtica dioica tops (nettle), 5 drams             tonic

Echinacea angustifolia root (echinacea), 3 drams    antiseptic, immune tonic

Juniperis communis berry (juniper), 2 drams         antiseptic urinary tonic

Symphytum officinale root (comfrey),1 dram         demulcent, corrective

Signature: Shake well and take ½ dropperful b.i.d. during this time and always a dose before intercourse.

Topical: Hypericum perforatum oil as a vaginal lubricant before and during intercourse used liberally. Avoid sex with burning friction.

Follow-up: 3/20/86

Doing much better. Loves the lubricant as does her boyfriend. Thinks this has helped her more than anything. Wants to tell the world! Wonders if there is a way to have more staying power as it is absorbed. I recommend a salve. She wants some of both. Finished the tea “Thank God.” Would do another round of it but would like to wait. Likes the extracts and wants to continue taking them for awhile. Is feeling better all over, especially joints and urinary tract. Sometimes feels like she is getting that achy feeling and feels a spasm in her urethra, but it doesn’t continue to a full blown infection. Has discontinued the macrodantin. Skin and eyes look clearer and people are commenting on her vitality and color. Really trying to eat better and avoid soda pop. Misses that afternoon can or bottle of pop. Herb tea just doesn’t do it. Is very grateful to have a wholistic approach that holds her accountable. Really believes in wholistic health care. Likes the slippery elm gruel and wants a refill. It is a comfort food after a long day of hearing people’s troubles.

Copyright 2001 Paul Bergner    401


    Medical Herbalism: Clinical Articles and Case Studies

Calendula officinalis (marigold), Hypericum perforatum (St. Johnswort) salve in an olive oil, cocoa butter, beeswax base, two 1 oz jars

Hypericum oil (fresh flower/bud in olive oil) 2 oz bottle


Chimaphila umbellata tops w.c (pipsissewa) 5 drams     urinary antiseptic, alterative

Echinacea angustifolia root w.c., 4 drams         immune tonic

Juniperis communis berry w.c. (juniper), 3 drams     urinary antiseptic/tonic

Commiphora myrrha (myrrh),1 dram             urinary antiseptic/tonic

Thymus vulgaris leaf (thyme), 1 dram             antiseptic, antispasmodic,                                             adjuvant

Mentha spicata (spearmint), 1 dram            refrigerant diuretic

Apis, ½ dram                        urinary tonic

Cantharis, ½ dram                     urinary tonic

Signature: Shake well and take 30 drops in a little water qid 5 days per week.


Doing continually better. Has picked up a number of refills of oils and salves. Really doesn’t drink pop and has decreased sugar. Eating more grains, beans, and vegetables. Is a great water drinker now. Beginning an intense PhD program and wants to stay energized and balanced. Exercising more to balance her sitting. Wants a general tonic.


Panax quinquefolium root (american ginseng)    4 drams    adaptogen

Angelica sinensis root (dong quai), 2 drams            pelvic tonic

Polygonum multiflorum (fo-ti; he shou wu), 2 drams        tonic

Signature: Shake well and take 30 drops twice daily until gone. Call and we will reevaluate whether to refill.


Would like to get a 4 oz size bottle of Panax  blend. Feels great. Agrees to use it for another 3 weeks and then rest 3 weeks and repeat for another 6 weeks if needed.
Copyright 2001 Paul Bergner    402


    Medical Herbalism: Clinical Articles and Case Studies    

Additional conversations and other contacts over 10 years reveals a woman who can control her syndrome which can still rear its head if she is not “good” with her diet and lifestyle. Has gone on to buy commercial herbal products as I was not as available for sessions and products. Is glad that herbs are so “in” now and available.
Copyright 2001 Paul Bergner    403