A Case of Recurrent Cystitis

Gail, age 27, was suffering from a case of acute pyelonephritis when
she first came to see us one year ago. She had short brown hair, delicate
features, and was soft-spoken. She was on antibiotics at the time. She had
experienced six episodes of cystitis over the past year, every two months. She
had seen four different doctors without relief. The symptoms of the
pyelonephritis included extreme dysuria (3), nocturia “every five minutes” (3),
chills (2), nausea (2), and faintness (2). She had profuse hematuria (3) and
her kidneys ached (2).

At the time of the initial onset of the cystitis, one year previously,
Gail had been laid off from her department store sales job. She had just begun
a new sexual relationship and had frequent sex after a period of sexual
inactivity. At that time she experienced a sense of urgency, urinary frequency,
urethral pain during urination, and sandy urine.

Gail had a happy childhood. She was sexually active for the first time at 14.
She married at 20. Her husband was 14 years older. She knew it wasn’t right
before she married. He had been fired from a job because of drug abuse, which
she did not know at the time. After they married, she attended art school and
worked full time to support both of them. She kept telling herself, “If I love
him enough and take care of him enough, he’ll take care of me.”

They moved to Alaska. He continued to be out of a job and she threw herself
more and more into her work. He eventually got a job in a porno shop. She
didn’t find out where he was working until they filed their tax return. He
lied, used drugs, drank, and probably had affairs. She kept trying to make
things work. He became increasingly threatening and intimidating.

After five years of marriage, Gail was diagnosed with cervical dysplasia. Her
Pap smear was a Class III. She had a lot of resentment at the time, but still
wanted to prove to her father that the marriage could last. She didn’t want to
abandon her husband. Six months later, she had a Class IV Pap, which was
treated with conization. She remained on oral contraceptives the entire time.
After another eight months, the Pap remained unchanged. She had laser surgery.
At that time she discovered Love, Medicine, and Miracles, which
inspired her to leave her husband.

She remained with him for two more years, but had a lover. She eventually
moved out secretly because she feared retaliation. Her husband became violent
when he realized she was leaving him.

Gail felt guilty after she left her husband. She visited him regularly because
he would lament about how lonely he felt. She went to counseling with him
because she felt he needed help getting his life together. During this time he
continued to go through her possessions and take money. While he was sorting
through her things, he discovered she was seeing another man.

The next time she visited her husband, she encountered a thunderstorm.
Lightning hit the tree in front of her. The tree caught fire and she became
terrified. She was still guilty about abandoning the marriage and felt she owed
it to her husband to talk to him again. Her husband pulled out a gun and began
to assault her. She let him do it because she feared he’d kill her. He tried to
rape her. Even after this episode, Gail continued to go out to dinner with him
occasionally.

She began to attend Al-Anon meetings and moved to another state without
leaving a forwarding address. She found a new lover who treated her very well.
It was hard to believe how good he was to her. She still feared her ex-husband
would find her and kill her new boyfriend. She continued to feel very anxious
whenever she saw a car like his.

Gail’s Paps were normal for the past two years. Her first normal Pap occurred
six months after she left her husband. Her sexual energy was high.

Gail had a tendency to moles (2). She had one suspicious mole biopsied. It
was benign, but she still visited a dermatologist regularly. She had axillary
skin tags. She complained of sinus congestion (2) and a poor sense of smell
(2). She was photophobic (1). Gail had herpes on her lips (1) when she became
overly nervous or tired. It began at age 13 when she began to play the flute.
She also had infrequent outbreaks of genital herpes (1). She had suffered from
ulcers ten years before.

She always had cold hands and feet (2). Her sleep was good. She usually alept
on her back or left side. She liked cheese, pasta, tomatoes, spicy food, and
ice cream (all 2’s). She disliked milk (2). She had average thirst (2). She was
not a morning person and she often felt sluggish for the first few hours after
waking.

Gail described herself as “quick to anger” (2). She tended at hold the anger
inside. She felt insulted easily (2) and became defensive if her ability was
called into question (2). She was usually pretty mild (2), however.

Now study the case and click here to view the case analysis.
Those of you who are familiar with homeopathy will find this to be a very
clear-cut case. This is a typical presentation of the remedy
Staphysagria (Stavesacre). Staphysagria is one of the most
prominent homeopathic remedies for bladder infections, particularly of the
“honeymoon cystitis” variety. The symptoms of the individual case of cystitis
can vary. It is often the etiology as well as the personality type of the
individual that leads to the prescription of this remedy.

People needing Staphysagria very often experience sexual abuse during
childhood and may begin to develop urinary symptoms at that time. The other
typical time of onset of their cystitis is after first becoming sexually
active. In Gail’s case, there was no known sexual abuse and the urinary
symptoms began later in her life. This is actually surprising, given how well
she fit the remedy picture.

Though this remedy can also be given to men, we will concentrate here on the
presentation of Staphysagria in women. This remedy is the classic
battered women’s remedy. The woman tends to have low self-esteem. She is
generally very sexual and becomes involved in relation-ships with domineering,
often abusive, men. She holds her anger inside, backs off from confrontations,
and blames herself for the conflicts. She keeps hoping she can make things work
by being a better wife or love…if she could just be more perfect. She may
become so angry that she throws things, but generally the anger will remain
suppressed. She may stay in a violent relationship for years because she is
afraid to leave. After taking the remedy, it is not uncommon for such a woman
to leave the abusive relationship or situation.

In addition to urinary symptoms, people needing Staphysagria may
develop styes, stupefying headaches, severe dental decay, vaginitis, and
abdominal pain after anger.

At Gail’s first visit, we gave her Staphysagria 30C to take as needed up to
twice a day for the next few days. We also gave her cranberry capsules and an
herbal urinary combination. We instructed her to stop using the contraceptive
sponge.

Gail called two weeks later to say she was doing very well. She had a herpes
lesion on her lips, which we interpreted as the return of an old symptom,
generally confirmatory that the chosen remedy is correct. At her follow-up
visit six weeks after we first saw her, she was feeling “really good”. There
was no dysuria or aching in the kidneys.

Her urine was no longer sandy. She had no PMS or menstrual cramps. She got a
new job and was feeling more positive mentally. She felt more creative and
better able to make decisions. She felt irritated again for about one week
recently. She had a brief bout of conjunctivitis for which she used an
antibiotic ointment. We assessed that the remedy had acted curatively.

Two weeks later Gail experienced another episode of cystitis. The symptoms
were the same as before, though milder. She had taken a dose of
Staphysagria 30C with only temporary improvement. We decided that she
needed a higher dose of the same remedy and gave her Staphysagria
200C.

We saw her again five weeks later. She was doing well except for outbreaks of
perianal and vaginal herpes, each lasting one week. She had a recurrence of a
bump on her left palm which also came and went in one week. She had this bump
previously for months. She had no urinary symptoms. She was very anxious lately
about moles (3). She had an increased desire for meat (2). She had a bad dream
about her ex-husband finding her. She woke up wanting to scream but couldn’t.
Since she seemed to be feeling well, we waited and did not prescribe the remedy
again.

At her next visit, two and a half months later, Gail reported that she was
completely over the previous acute illness in a week. She had been working 75
to 80 hours a week. Her boss finally agreed to hire an assistant for Gail.
“Maybe now I can have a personal life.” She realized that her urinary symptoms
often came on when she was angry and didn’t say anything about it. (The essence
of Staphysagria is symptoms from suppressed anger.) She was feeling
chilly. She just bought a new car. She recently dreamed of the wheels being
stolen- “like I don’t deserve it”.

She was experiencing some left foot pain. Again we waited.

Gail experienced another episode of cystitis one week later. She was again
working very long hours and attending evening meetings. She felt exhausted (2).
Like before, her kidneys ached (2) and she had urinary urgency (2). Her voiding
was incomplete (2). She had a sharp urethral pain at the end of urination (3).
We again gave her a dose of Staphysagria 200C.

We gave her some Sarsaparilla 30C to take home in case the Staphysagria did not
work. Sarsaparilla is a commonly needed remedy for acute UTI’s with
urethral pain at the close of urination. She called the next day to say she was
better.

We last saw Gail three months later. She had committed herself not to work
weekends anymore. She was standing her ground more. She had no bladder
problems. “I’m in a good frame of mind.” She had no menstrual symptoms. “I’m
still trying to deal with some of my pent up hostilities. I feel positive more
and more often. I’m much stronger. I don’t dwell as much on past problems. I
feel more together spiritually and physically. I am more comfortable in my
relationship. In the past I thought I didn’t deserve such a wonderful guy. Now
I know I do.”

This case is interesting for several reasons. First, it is a classic
presentation of a frequently needed remedy. Secondly, it is a case in which the
acute and constitutional remedy for cystitis are the same. Thirdly, we see the
skin eruptions, in this case herpes, coming to the surface while healing occurs
on a deeper level. Fourth, we see that as long as Gail stresses herself way
beyond her capacity, she still has a tendency to cystitis. It resolves quickly
with Staphysagria. Had she reduced her stress by reducing her work load,
she may have had any recurrences of the cystitis. Lastly, we see that, in
addition to decreased frequency and rapidly resolution of the cystitis, her
other chronic physical symptoms resolved and she felt much stronger mentally
and emotionally. As Gail continues with homeopathy, this trend should continue.
We expect that she will feel increasingly able to stand up for her needs and be
more at ease with accepting a kind and loving relationship.

Dr. Judyth Reichenberg-Ullman and Dr. Robert Ullman are licensed
naturopathic physicians and are board certified in homeopathy. They are
President and Vice President of the International Foundation for Homeopathy
where they teach homeopathy to licensed health care professionals. They
practice in Edmonds, WA at 131 3rd Ave., N., Edmonds, WA 98020 and can be
reached at (206) 774-5599. Their new book, The Patient’s Guide to Homeopathic
Medicine, is now available.