ELDERLY men past the fifties or sixties frequently suffer from enlarged prostates. They notice that they find it difficult to hold their water, that the urinary stream becomes weaker and weaker, that they have to get up a number of times during the night, and at last they go to the doctor and complain about their trouble.
As a rule, the doctor, whether he is a humble general practitioner or an eminent man, well ask a few questions and he may examine the patient more or less perfunctorily, and will then tell him that he ought to go to a bladder specialist, and that in all probability an operation will be necessary.
The unfortunate individual, who had hoped that a few doses of medicine would improve his trouble, leaves the doctors consulting room deeply disheartened. He did not know that he had an enlarged prostate and he dreads the visit to the bladder specialist who will charge him a number of guineas. He discusses the position with his friends and relatives, and at last makes up his mind that he will see the bladder specialist.
The bladder specialist will immediately draw off the urine in a catheter, look at it against the light in order to see whether the urine contains pus or shreds of skin, and will test its gravity. He may examine the prostate with the finger by way of the back passage, but as a rule he will consider this procedure too elementary, and he will explain to the patient that it is necessary that his bladder and the condition of his prostate should be examined with a cystoscope.
The cystoscope is a hefty tube about as thick as a pencil, with a mirror and an electric light at the end of it. It is inserted into the bladder and then the specialist can look at all parts of the bladder and see quite clearly the local position. Unfortunately the use of the cystoscope, though satisfactory from the specialists point of view, is not very satisfactory from the patients point of view.
If the urinary passage is very wide there is little risk in inserting a cystoscope if the specialist is cautious but if the cystoscope is inserted into a narrow urinary passage, then considerable strength has to be used and the walls of the passage may be torn or there may be injury to the swollen prostate or to the bladder walls, and this would be a very serious matter.
Bladder specialists very frequently recommend that the examination should be done under a local or under a general anaesthetic. the latter method would involve considerable additional expenditure, especially as the examination would probably be done at a nursing home or hospital. Besides, the insertion of the thick tube under an anaesthetic is most undesirable because the patient cannot feet the pain and is unable to protest against the violence done to him, and after the investigation is over he might be much worse.
General practitioners have been taught by bladder specialists that the only treatment for enlarged prostate is operation. Operations for enlarged prostate are not satisfactory. The patient has to lay up a long time, and the percentage of patients who die soon after the operation, or who become complete invalids in consequence of the operation, is considerable. Let us now see what the skilled homoeopath will do if approached by a patient suffering from enlarged prostate.
The homoeopath who understands his work will not send a prostate case to the surgeon unless he has come to the conclusion that the case is so serious that non-surgical treatment would be hopeless. He should go into the health history of the patient and enquire into his medical inheritance. If he should find out that the patient has had gonorrhoea or syphilis, or both, he should take careful note, and he should treat him for gonorrhoea, syphilis or both, If the patient has a tuberculous inheritance he should certainly be treated for tuberculosis which in some way or other may have affected the bladder condition, for after all we do not know the inter-connection of diseases.
In the older times the only from of tuberculosis known to the medical profession was tuberculosis of the lungs. We know that tuberculosis may affect any part of the body, the there may be tuberculosis of the brain, of the stomach, of the eyes, of the skin, of the finger and toe nails, etc. So i consider it the duty of the homoeopath who wishes to handle a case of enlarged prostate, to survey the body as a whole, while, of course, not neglecting the bladder condition.
The skilled homoeopath will not use the cystoscope, and he need not, as a rule, use a catheter, but he should examine the prostate by way of the back passage. the forefinger of the prescriber should be covered with a rubber finger-stall, and it should be thoroughly greased with vaseline and then inserted into the back passage. The patient may be recumbent on his side with his knees drawn up, or he may be examined standing and leaning forward. Each medical man has his favourite way of examining such cases. By inserting the finger into back passage one can discover many interesting facts.
One can feel the exact size and enlargement of the prostate. The prostate may be very large and soggy, or it may be comparatively small and story hard, it may be a healthily enlarged prostate or it may be a prostate which is irregularly enlarged. Great irregularities suggest the possibility of cancer, and so does sogginess of the gland. Then it should be noted whether a little pressure causes considerable pain, little pain or a slight discomfort. Further the condition of the bowel should be examined in every direction, and notice should be taken whether there is much or little pile tissue.
When the medical history and medical inheritance have been carefully gone into, then the patients diet should be studied in fullest detail. It may be found that the patient takes large quantities of alcohol, salt, pepper, mustard, vinegar, pickles, meat, etc., which irritate the kidneys and bladder by producing very irritating urine, or it may be discovered that the patient takes the absolute minimum of liquid because he wishes to avoid bladder pressure and frequent urination. The less liquid he takes, the more concentrated the urine will become, and the greater his sufferings.
The prescriber should explain to the patient that he makes a mistake in taking strongly spices, heating food, thus causing inflammation of bladder and prostate, that he makes a great mistake in taking far too little liquid, and he should be put on a bland diet, fleshless and fishless, with a superabundance of non-irritating liquid, water, lemon water, superlatively weak China tea, etc.
It the patient lives on a devitaminized and demineralized diet, then drastic changes should be made and the patient should be given the maximum of raw fruit, salading and so forth. Aluminium should be eliminated from the kitchen. Over- consumption of tobacco should be stopped.
Correction of the dietetic mistakes of the patient alone will probably bring immediate relief to the prostate sufferer. He will find that the holding capacity of the bladder is greater, that the stream gets stronger, no longer afraid of complete stoppage. Further, he should be told what to do if a stoppage should occur. If sudden inflammation occurs in the bladder, then the urine may be retained.
The retained urine would get foul, and the putrid infection might spread up the ureters to the kidneys and cause trouble in the kidneys as well. As a rule one can relieve such a stoppage by a sitz bath, which means a bath of the lower abdomen, or by hot enemas containing a little Belladonna. Besides outer heat might be used with advantage. Hot poultices might be placed on the lower abdomen in the blade region, etc.
When all these common-sense measures have been taken, then the question of medication arises. The prescriber should study the treatment of prostates in books such as Clarkes Prescriber, and particularly Kents Repertory. the prescriber will find under the heading ” Prostate–Enlargement” a number of remedies, and he should endeavour to select that remedy or those remedies which seem particularly indicated in the case before him. He should not only treat the prostate, but he should treat the body as a whole.
If the patient is hot-blooded, has a dark skin, dark hair, dark eyes, is irritable, constipated, fond of strong spices and condiments, alcohol, tobacco, he will need Nux vomica in some form or other. If he has strong Sulphur symptoms, or Arsenic symptoms, he should be given Sulphur or Arsenic.
His inheritance and old infections should be dealt with in the usual way, and in addition he should be given some suitable specific for his bladder trouble such as Sabal serrulata, Silica, if the prostate is story hard, Aurum iodatum which I usually given in the 4x potency between meals, if the symptoms should be found under Aurum iodatum, Pulsatilla if there are strong Pulsatilla symptoms, Conium if there should be strong conium symptoms, and so forth. Further , the patient should be urged to follow a suitable diet and to avoid chilling of stomach and abdomen or feet, which may produce a considerable aggravation and possibly lead to a stoppage.