Acute cystitis and its homoeopathic management with Murphy’s repertory

Dr Nandha Subbian

ABSTRACT
This article is an attempt made to explain acute cystitis in females and the reportorial approach using Murphy’s Repertory and indication of some of the commonly used homoeopathic medicines.

KEY WORDS : Acute cystitis, Homoeopathy, Murphy’s Repertory

INTRODUCTION
According to 2018 ICD-10-CM American version, Cystitis is defined as the acute or chronic inflammatory process affecting the bladder either from bacterial or nonbacterial cause. It is usually associated with painful urination/dysuria increased frequency, urgency and suprapubic pain. (ICD-10 CM – CODE N.30.0)1.

Acute cystitis is one of the most common diseases that affect all age groups ranging from neonates to the geriatric population. About 150 million people worldwide are diagnosed with UTI each year, accounting for one-fifth of emergency visits in outpatients department. Additionally, about 40-50% of women in the reproductive age group (15-49 yrs) have a history of at least a single episode of UTI in their lifetime2.

Females are more prone to suffer because of short urethra, close proximity of anus and urethral trauma during the intercourse. Although majority of infections are acute and short lived they contribute to a significant amount of morbidity and health care expenditure in the population3. Approximately 5% of young women experience new infection each year and the rate increases with increasing age.

Acute cystitis although generally self limiting if it is left untreated, it can cause serious illness like permanent damage to the kidney, thus can also cause life threatening situation. Treatment with the antibiotics can lead to a more rapid resolution of symptoms and is more likely to clear bacteria’s but also develops resistance to uropathogens and adversely affects the gut and vaginal microbes.  As the uropathogens are increasingly becoming resistant to available common antibiotics, it becomes difficult to treat even with the isolation of bacterias4

CLINICAL FEATURES OF ACUTE CYSTITIS 

  1. Frequent urination of small volumes of urine 
  2. Urgent urination 
  3. Feeling pain or burning while urination 
  4. Incomplete bladder emptying 
  5. Pain or discomfort over suprapubic region 
  6. Visible blood in the urine 

CAUSES 

  1. Bacterial causes 
  2. Irritating hygiene products 
  3. Maintaining improper hygiene 
  4. Engaging in sexual activity
  5. Complication of certain disease like diabetes 
  6. Adverse reaction to certain drugs 
  7. Long term use of catheter 
  8. Less water intake 

DIAGNOSIS 

Clinical symptoms
Urine routine and urine analysis with significant presence bacteriuria of 105 or more colonies per millimeter of midstream urine.

PLAN OF TREATMENT
Since acute cystitis is an acute painful and disturbing condition which affects the quality of life of a person too. In such conditions detailed case taking is a cumbersome work and hence clinical rubrics may play a vital role in arriving at the similimum in no time.

Homoeopathic medical Repertory by Robin Murphy’s  is a modern alphabetical Repertory, is mainly based on Repertory of homoeopathic Materia medica by Dr. J T Kent and Repertory of  Hering’s guiding symptoms of our Materia medica by Calvin B Knerr.

This Repertory is based on principle of clinical as well as classical homoeopathic practice. It is one of the valuable repertories which help to find out the similimum based on the clinical diagnosis. 

RUBRICS RELATEDTO CYSTITIS IN MURPHYS REPERTORY 5

CYSTITIS, bladder, inflammation: (154)ACON. all-c. alth. alum. am-c. anan. ant-c. Ant-t. APIS aq-mar. Arg-n. arist-cl. Am. Am. ars-s-f. aspar. bac. bats-p. bamb-a. Bar-m. baros. BELL. benz-ac. Berb. bism. Bor-ac. cact. Calad. Cala calc-p. calc-s. camph. camph-ac. cand-al. Cann-i. cann-s. CANTH. Caps. carb-an. carb-v. Caust. cham. Chim. Chinin-s. cinnb. clem. coc-c. colch. coloc. Con. Cop. Cub. Dig. Dula elat. epig. EQUIS-H. erech. erig. Ery-a. eucal. Eup-pur fab. ferr-act. ferr-p. foil. gali. Gels. graph. grin. guaj. guare. hedeo. Hell. Hep. Hydr. hydrang. Hyos. ign. iod. Juni-v. kali-ar. kali-bi. kali-c. kali-chl. kali-m. LACH. lith-c. LYC. MED. Mew. MERC-C. merc-i-r. methyl. mez. mill. Morg.
morg-g. musa mut. myrt-c. nat-c. Nit-ac. Nux-v. Ol-sant. op. pareir. petr. petros. ph-ac. phos. pip-m. plb. polyg-h. pop. prot. prun. PULS. rheum Thus-a. Rhus-t. ruta sabal Sabin. santin. SARS. Saur senec. seneg. SEP. silphu. solid. squil. STAPH. Stigm. stram. sul-ac. Sulph. syc. tarent. tax. TER. that. THLAS. thuj. tritic. tub. uva verat. verat-v. vesi. xanth. zea-i.

– abortion, from: (1) rheum

– bleeding, with: (3) canth. merc-c. Nit-ac.

– burning, pain, with: (2)Arg-n. cann-s.

– cantharis, from abuse of: (3) apis camph. Canth.

– catherer, after: (5) acon Calen. camph. canth. Staph.

– childbirth, after: (1) staph.

          – chronic: (56) Am. bals-p. Baros. Benz-ac. berb. Cann-s. CANTH. carb-v. Caust. Chim. coc-c. coloc.  Cop. cub. Dula Epig. ery-a. eucal. Eup-pur. fab. grin. Hydr iod. juni-v. Kali-chl. Kali-m. lith-c. lyc. Med. Merc-c. mut. nat-c. nit-ac. Pareir. pip-m. Pop. prun. Puts. Thus-a. Sabah santin. seneg. Sep. silphu. STAPH. Stigm. Sulph. Ter. THLAS. thuj. tritic. Tub. Uvavesi. xanth. zea-i.

      enlarged prostate, with: (1)fab.

– cold, from taking: (19) acon alum. ant-t. Apis arist-cl. bamb-a. Cala calc-p. canth. cop. DULC. hep. lyc. op. PULS. rhus-t. SARS. Sulph. ter.

– fever, with: (12)Acon. ARS. bell. calc-s. Canth. ferr-p. gels. hydrang. Kali-chl. stigm. tarent. VERAT-V.

  • strangury, with: (6)Acon. bell. Canth. gels. hydrang. stigm.

– gonorrhea, from: (10)Arg-n. bell. benz-ac. Cann-s. Canth. Cop. cub. merc-c. puls. sabal – headache, with: (1) rhus-t.

– hemorrhoidal, flow, after suppressed: (1)Nux-v.

– injuries, after: (5)Am. CALEN. canth. mill. Staph.

– menses, during: (1) senec.

  • amel.: (1) Sars.
  • before: (1) senec.
  • suppression of, after: (1)Nux-v.

– miscarriage, from: (3) rheum sep. staph.

– mucopurulent, discharge, with: (1) baros.

– neck, of: (31)Acon. Apis aspar. baros. camph. Cann-s. Canth. Caps. cham. Chim. Clem. con. Cop. Dig. elat. guaj. hyos. ign. lyc. Merc-c. Merc-i-r. Nux-v. Petros. plb. Pubs. ruta Sam. Senec. staph, sul-ac. sulph.

  • mucopurulent discharge, with: (1) baros.

– pain, with violent, and almost clear blood: (1)Nit-ac.

– pregnancy, during: (2) calen. pop.

– prostatic, hypertrophy, with: (1) sabal

– pulsating, throbbing all over, with: (1) sabin.

– pus-like, discharge after lithotomy: (2) calen. mill.

– recurrent (9) aq-mar. cand-al. foil. lyc. med. morg. puls. sep. tub.

– riding, over rough roads, from: (1) eup-pur.

– scarlatina, after: (1) Canth.

– shooting, pain, with: (2)Arg-n. cann-s.

– surgery, from: (4) calen. methyl. mill. pop.

– throbbing, all over, with: (2) bell. sabin.

– violent, pain and almost clear blood, with: (2) Canth. Nit-ac.

– women, in: (3) cop. foil. staph.

  • elderly, in: (1) cop.
  • newly married, honeymoon cystitis: (2) Calen. STAPH.

SOME OF THE COMMONLY USED HOMOEOPATHIC MEDICINES IN ACUTE CYSTITIS

Sepia
Sepia is immensely useful for recurrent urinary tract infections, especially when there is also a history of lots of antibiotic use and thrush. The woman often loses her libido; because sex is painful and she fears cystitis may result. She is often worn out by the recurrent infections, so exhausted by the struggle to keep going that she cries when expressing herself.

Rubrics covered by sepia 

  • Cystitis, bladder, inflammation 
  • chronic
  • miscarriage from 
  • recurrent

Pulsatilla.
Pulsatilla is often prescribed for older women. The pain is worse when urination is delayed, and after urination. The symptoms are changeable, and the urine tends to spurt out.

Rubrics covered by pulsatilla

  • cystitis,bladder, inflammation
  • chronic 
  • cold,taking from
  • gonorrhea,from
  • recurrent 

Cantharis
The Spanish fly is a urinary tract irritant. It produces the most agonizing pain before, during and after urination. Each drop of urine feels like scalding acid and it may be easier to pass urine in a hot bath. The surrounding skin may become excoriated, and there may be blood in the urine. The patient is beside herself with pain and avoids drinking so that she won’t have to pass urine.

Rubrics covered by cantharis 

  • Cystitis,bladder, inflammation 
  • bleeding,with 
  • cantharis, from abuse of 
  • catheter, after
  • chronic
  • cold, taking from 
  •  fever,with
  • injuries,after 
  • neck,of
  • scarlatina,after 
  • violent,pain and almost clear blood,with 

Nuxvomica
There is intense chilliness and the person feels very irritable with the cystitis. There is constant urging and a sense that the bladder is full, although tiny amounts of urine are passed. This remedy is well indicated when frequency is the predominate symptom. 

Rubrics covered by nux vomica

  • Cystitis, bladder inflammation
  • hemorrhoidal, flow, after suppressed 
  • menses, suppression of, after 
  • neck of 

Staphysagria
“Honeymoon cystitis” frequently responds very well to Staphysagria, as do urinary tract infections that come on after pelvic examination, sexual intercourse, operation or labour. It is indicated where there is suppressed anger and grief and the pain is felt during and after urination.

The rubrics covered by staphysagria

  • cystitis, bladder, inflammation
  • catheter after 
  • childbirth, after 
  • chronic
  • injuries, after 
  • miscarriage from
  • women , in 
  • women, newly married, honeymoon cystitis

Sarsparilla
This remedy is frequently used for infections when the pain comes on after urination. There may be some blood in the urine. It is easier to pass urine whilst standing up and there is a tendency to urinary retention

Rubrics covered by sarsaparilla  

  • Cystitis , bladder, inflammation 
  • cold, from taking 
  • menses, amel

Apis mellifica

This remedy is indicated when the person frequently needs to urinate, but only small quantities are passed. Stinging and burning sensations are felt (especially with the last few drops) and the person may also experience soreness in the abdomen. Heat and touch make the symptoms worse, and cold applications, cool bathing, and open air bring relief. A lack of thirst is another indication that Apis may be needed.

Rubrics covered by apis mellifica

  • Cystitis , bladder inflammation
  • catharis,abuse of
  • cold,taking from 
  • neck,of

Belladonna
This remedy may be beneficial if urging to urinate is frequent and intense, and the bladder feels very sensitive. A cramping or writhing sensation may be felt in the bladder area. Small amounts of highly-colored urine pass. (This remedy is sometimes helpful if a person passes small amounts of blood and no serious cause can be found on medical examination.)

Rubrics covered by belladonna

  • Cystitis,bladder,inflammation 
  • chronic
  • cold,taking from
  • neck ,of
  • recurrent
  • throbbing,all over with 

Lycopodium
This remedy may be helpful if a person has to urinate frequently during the night and passes large amounts of urine. Or the person may feel a painful urge, but has to strain to make the urine flow. Pain may be felt in the back before the urine passes

Remedies covered by lycopodium 

  • Cystitis, bladder,inflammation 
  • neck,of
  • recurrent 

REFERENCE 

1. Codes I. 2019 ICD-10-CM Diagnosis Code N30.00: Acute cystitis without hematuria [Internet]. Icd10data.com. 2019  https://www.icd10data.com/ICD10CM/Codes/N00-N99/N30-N39/N30-/N30.00

2. Das A, Banerjee T. Prevalence of Urinary Tract Infections and Susceptibly Pattern of Uropathogens in Women of Reproductive age Group from North India. Journal of Advances in Medicine.2015june-december; 4(1and2):5. http://ndpublisher.in/admin/issues/JAMV4N2b.pdf

3. SK Akmalhassan, T Naveen kumar, N Radhakishan, K Neetha. Laboratory diagnosis of urinary tract infections using diagnostics tests in adult patients. International Journal of Research in Medical Sciences.april-june2014;2(2):415.https://www.msjonline.org/index.php/ijrms/article/view/2165/2023

4. Foxman B. The epidemiology of urinary tract infection. Nature Reviews Urology.Decmber2010;7(12):653-660. https://www.nature.com/articles/nrurol.2010.190

5. Murphy R. Homoeopathic Medical Repertory. 3rd ed. Noida: B.JAIN PUBLISHERS (P) LTD.; 2016.194-195 p.

Dr Nandha Subbian
Department of Case Taking And Repertory
Govt. Homoeopathic Medical College, Bangalore
Karnataka  560079

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