Vol. 21 No. 3 June 2001

by Bruce Barwell and Dilip Dixit

Many women come to our clinic wanting treatment for cystitis. Some have had antibiotics plus things to make their urine more alkaline (such as Citrivescent and Ural); others have tried natural remedies like calcium ascorbate and cranberry extract.

These measures alone work in quite a high percentage of cases, but cystitis is very prone to return.

The most commonly suggested remedy in homœopathic textbooks is Cantharis, with Staphisagria second. Experience bears out the usefulness of these two remedies. Probably with just these alone a prescriber would get better results than with the use of antibiotics.

The organism often to blame for cystitis is Escherichia coli, called Bacillus coli or B coli in older homœopathic books. The nosode made from Escherichia coli is usually called E coli in homœopathic pharmacies. In 30c potency it is very useful for cystitis even if laboratory tests of the sufferer’s urine do not report the presence of E coli in significant quantity or even at all.

It is especially successful in treating cystitis in young boys.

E coli is a common bowel bacterium, and the usual way it gets into the bladder is said to be from faeces, even in minute quantity, ascending the urethra to the bladder. Tardiness in removing a stool¬filled nappy from a baby, or careless washing of a soiled baby, can be blamed.

In adults there may be a small, harmless resident population of E coli in the bladder which may multiply to painful numbers if urine pH changes, or following vigorous sexual activity, or after intercourse following a time without it. It is not invariably the case that the male partner is responsible for introducing the germ.

Other cystitis remedies that may be needed are Copaiva, Cubeba, Populus (candicans or tremuloides) and Barosma. These are just leading ones; there are many others that may be needed in rare cases that do not respond to the seemingly indicated remedy or have some peculiar symptom to suggest their use.

Copaiva: Constant desire to urinate; itching, scalded feeling in urethra or concentrated at its orifice before and after urinating; urine may have an almost floral smell.
Cubeba: Urine foamy, albuminous, bloody; sometimes causes bed wetting, or almost so.
Populus: Quite like Cantharis (can even produce big blisters) and Benzoic acid (but the urine is not nearly so strong smelling). Urine reddish, or different colour each voiding. Small particles like skin shed from bladder lining. May be no pain when actually urinating.
Barosma: Known to herbalists as buchu. Lot of shreds of mucus, with shed skin and pus-like particles. Useful when acute pain, etc, subsides but above symptoms persist.

I use Cantharis 1M, Staphysagria 200c, and the others in 30c, given from hourly to three times a day as indicated.

Here are some cases illustrating the use of E coli in the experience of the Mumbai (Bombay) homœopath Dilip Dixit. Dr Dixit’s report was first published in the Homœopathic Heritage of October- December 2000.

Amongst the bowel nosodes I have found E coli as the most useful in day to day practice. There have been few references available to the proving of this remedy. Apart from those mentioned in the proving, most of the uses of this remedy are empirically as a nosode. Its main sphere of action appears to be the urinary tract. There have been few specific indications, which have been verified time and again:
1. Asymptomatic, chronic, recurrent urinary tract infections.
2. Lower urinary tract infections seen in children and women.
3. Mild evening rise of temperature.

Some cases from my practice are enumerated below.

Case 1
Female, 78 years old, generally in good health. Constitutional remedy – Natrum muriaticum. Past history of occasional headache and malarial fever (once). Had a fall in the bathroom leading to fracture of neck of femur; nail inserted after operation. She developed low grade fever 15 days after operation. Several strong antibiotics were tried. Patient came down with swelling of the feet and puffiness of the face. Urine output was reduced.

Examination of blood revealed increase in serum creatinine and urea levels. Routine urine showed pus cells, 200-300/hpf. At this juncture homoeopathic treatment was commenced.

Rx Pulsatilla 200c, 4-hourly. After 5 days, urine showed pus cells, 1-3/hpf. Urea, creatinine nil. No puffiness and swelling.

She was then given Tuberculinum 1M, 1 dose followed by a dose of Natrum muriaticum 200c. Patient was better for 3 days. After 3 days swelling and puffiness started again. Urine pus cells were 50-60/hpf.

Creatinine was nil. Urine culture showed E coli.

Rx. Pulsatilla 200c 4-hourly was resumed. Patient was asymptomatic but repeated urine examination showed pus cells 50-60/hpf. Puls 200c, 4-hourly, and E coli 30c, 1 dose weekly was continued for 6 weeks. Subsequently, there were no other infections and pus cells remained between 1-2/hpf. Later Nat m 200c was repeated once and there were no other problems later.

Case 2
Female, 60 years. Her husband, who had been an invalid, bedridden for a number of years, had died 3 months ago.

Husband was extremely irritable, malicious and had been tormenting her for a long time. She developed sudden, acute anxiety attacks with hypertension, and consequently had a stroke. There was paralysis of hands, feet and the left side of face. She couldn’t swallow, so was fed by a gastric tube.

Tracheostomy was done. She also had urinary incontinence.

She was prescribed Causticum 30c and Tuberculinum 1M infrequently. Her paralysis and swallowing improved drastically to almost 100%. Tracheostomy and gastric tubes were removed. But she continued to get chills at midnight. Urine showed innumerable pus cells.

Rx. Arsenicum album 200c was given for urinary complaints. With it the pus cells came to 100-200/hpf, but no further improvement could be obtained. E coli 200c alone was given on a weekly basis. After the first week, pus cells came down to 10-12/hpf. It required 6-7 doses of E coli 200c and there was no recurrence.

Case 3
Girl, 9 years. Her constitutional remedy was Calcarea iodatum in infrequent doses with Tuberculinum 1M infrequently. Her acute remedy was Pulsatilla. A known case of recurrent urinary tract infections. Urine pus cells, 30-40/hpf. Came with complaint of pricking pain at the end of micturition. No fever, no burning. On examination, redness of the vagina. Systemic examination, nothing abnormal discovered. She was given Puls 200c, hourly for 2-3 weeks. The pain used to subside for 2-3 days before again returning. Tub and Calc i also were helping but only partially. Urine pus cells were 10-12/hpf. Two-three doses of E coli 2c with Puls 200c 4 times a day relieved all the symptoms. There was no occurrence of redness or any other complaint later.

Case 4
A female, 35 years had a prolonged history of cystitis. Had been treated by virtually all antibiotics by allopathic physicians. Repeated urine culture confirmed that the bacteria was resistant to almost all antibiotics. She also had shifting polyarthritis. Complaints aggravated during menses. Sexual desire increased during menses.

Her constitutional was Sepia. Presenting symptoms were frequency of micturition, burning pain before, during and prolonged after micturition. Aggravated after last delivery, 8 years ago. Sometimes she used to get fever in the evening. Constantly complains of being unwell.

Puls 200c used to tone down acute complaints but never relieved 100 percent. Complaints aggravated during menses. E coli 30c was given weekly but it didn’t help much. So E coli 200c was prescribed daily for 2-3 weeks with Puls 200c 4-hourly, which settled her completely and there has been no recurrence since in the last 20 years.

Case 5
A boy 6 years, was suffering from pyrexia (fever) of unknown origin for last two months. All the investigations were negative, except ESR which was 50mm/hour. He was investigated for possible congenital defects. Tuberculosis was ruled out. Even repeated urine examination showed 0-6/hpf pus cells except once when they were 30-40/hpf. The fever used to appear in the evening with mild chill between 7-8 pm. Otherwise the patient was hot. His constitutional remedy was Nat mur and intercurrent was Tuberculinum. The acute remedies, Pulsatilla, Arsenicum alb, Belladonna were given. All the standard approaches and therapeutic plans had failed to relieve him of the fever. His general condition improved under homœopathic treatment and there was a weight gain of 3 kg within two months. It was assumed that it might be atypical, chronic urinary tract infection. E coli for 7 days was given. On the third day, the fever disappeared and has not returned in 5 years.

Case 6
Master N, aged 6, had fever 39 C on 2/01/1996. It did not respond to allopathic treatment. At one point he was admitted to hospital due to high fever. It was eventually realised he had a urinary calculus. After that he was referred to a lithotripsy centre and had four extra-corporeal shortware lithotripsy sittings on 10/10/l996, 4/11/1996, 26/07/1997 and 12/04/1999. On the treatment which he was given on 12/04/1999 he suffered from severe pain and was admitted at his native place Pune on 20/04/1999 for 5 days due to “febrile convulsion” (high fever) .

His parents report, “After that most of the time we have consulted our family doctor. On April 15, 2000 we consulted Wadia Hospital where we were told to have diphtheria, tetanus and pertussis vaccinations. We got an ultrasound scan also. Right kidney – Duplication of pelvis scanning of the renal cortex in the lower polar region and at least 3 calculi in the lower polar calyces.

“If he consumes milk/milk products or any food that contains calcium, it results in an increase in pus cells, leading to fever. If he is given an antibiotic, it comes down.”

Weight 16 kg, as against expected the 22 kg. Height 106 cm as against the expected 120 cm.

Emotional nature – A little shyness and scared. Attached to mother/father but is mixed up with everyone in the family. Indolent.

Intellectual attainments – Obtains marks between 70% to 80%

Relationship with –
(i) Family members good.
(ii) Mixes easily with others
(iii) Teachers/school – Fears to talk, sometimes cries in school.
(iv) Tuition teacher – Scared of.

Food – No complaint, complete self control on not having milk/ milk products.

General environment – If it rains too heavily then gets a cold.

Sleep and dreams – Sleeps very soon. Rarely cries on seeing a nightmare. Grinding teeth during sleep.

Milestones – Child started sitting at 6 months, talking at 7 months, teething at 9 months, walking at 12 months, self toilet training at the age of 5 years.

Previously his pus cells range was between 120-150/hpf. After 3 sittings of lithotripsy it has come down to 2 5-30/hpf. But we have not yet been able to remove the cause of stones and pus cells.

Additional information:
Thermal – Sometimes feels cold, sometimes hot (but mostly feels cold).
Chilliness – more pronounced on lower extremities. Uses socks at night.
Covers up to waist only.
Craving for salt, chalk, slate pencil, raw rice. Obstinate, moody. Attached to father.

He was managed with his constitutional remedy Natrum muriaticum. Intercurrent, Tuberculinum and E coli. Acute, Hepar sulph and Pulsatilla.

He improved in general health, gained weight and his temperament changed, but pus cells in the urine persisted though the episodes of fever became better. He passed several small stones without much pain.

Only the introduction of E coli 30c, first at single dose frequency, then daily at bedtime, then thrice a day helped to bring the recurrent urinary infections under control.

Summary
From the experiences mentioned above and hundreds of other cases, the role of E coli as a deep acting remedy in miraculous cures of chronic urinary tract complaints is very certain.

You can see that in these six cases all the standard approaches had failed to deliver the desired results and only a timely intervention with a nosode made all the difference. It should also be noted that there is no routine advice for its application. The assessment of susceptibility and sensitivity played an important consideration in selection of potency and repetition.

We feel that it can be assumed that this remedy may have an important role in chronic bowel complaints and needs to be explored.