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The prostate, homeopathy and Sabal serrulata
The prostate, homeopathy and Sabal serrulata by Brian Kaplan
The first thing that should be said about the prostate is that it is one of the most mispronounced words in the entire English language. So many people pronounce it as “prostrate” which of course means “stretched out on the ground” – nothing to do with the prostate gland. Most men know very little about the prostate and a survey once showed that 89 per cent of men didn’t know where the prostate was located. Embarrassingly studies have also shown that women know more about the prostate and prostatic problems than men!
So what exactly is the prostate? It is an important walnut-shaped organ about the size of a golf ball, which surrounds the beginning of the urethra at the base of the bladder. And as everyone knows, only men have prostates. Its main function is to produce about 25 per cent of the semen in every ejaculation. This prostatic secretion protects and nourishes the sperm (produced by the testicles) and helps to prevent the urethra from becoming infected. It thus plays an important part in the male reproductive system. The prostate can be examined by the physician putting an index finger in the rectum – a slightly uncomfortable, but not painful medical procedure. Examination can reveal if the prostate is enlarged or hard in places. The prostate gland can be affected by three major types of problems.
Acute prostatitis is caused by a bacterial (and occasionally viral) infection usually as the result of a sexually transmitted disease such as gonorrhoea or sometimes as a complication of a urinary tract infection. Treatment is to identify the offending bacteria and prescribe the appropriate antibiotic. I see no place for homeopathy in the treatment of acute prostatitis.
Chronic prostatitis is more mysterious and troublesome to treat. Initial treatment in orthodox medicine is with antibiotics but even surgery is resorted to on occasion. I believe that homeopathy is well worth trying before resorting to the rather drastic option of surgery. Such treatment should only be attempted by an experienced homeopathic doctor.
Prostatic cancer is the most common cancer affecting men. In the UK, 27,000 new cases are diagnosed and over 10,000 men die of this dangerous cancer. It is much more common in elderly men with 80 per cent of cases occuring in men over 65 but it is not uncommon in men as young as 40. If left untreated it can spread to other parts of the body such as the spine and cause death. Rectal examination may or may not give a clue to the diagnosis. Fortunately there is a simple blood test that can screen for the level of prostate specific antigen (PSA). Levels above 10 do not prove cancer but indicate further investigations to be necessary. (Initially a repeated blood test and then a biopsy). There are those who believe all men over 40 should be screened for prostatic cancer but economic factors make this impossible for most of the world’s population. Even in prosperous countries, this severe (but often highly treatable) cancer goes undiagnosed because of ignorance. In his column in The Times 17 May 2004, Dr Thomas Stuttaford points out that 90 per cent of British men do not know the function of the PSA test (fortunately, 70 per cent of British women do) and he informs readers that a new help-line dedicated to prostate problems has just been set up, aptly called Ignorance isn’t bliss (020 8582 0248).
The management of prostatic cancer should always be in the hands of a qualified urologist. It may comprise surgery, radiotherapy, chemotherapy and drugs. Homeopathy can be used in conjunction with these treatments but never instead of them. This is a serious and potentially lethal disease and needs to be treated with the utmost respect.
Enlargement (Benign Prostatic Hypertrophy or BPH)
This is the most common problem affecting the prostate as it will eventually affect every man if he lives long enough! The enlarging prostate starts to press on the urethra and slowly obstruct it. BPH can present with any of the following symptoms all of which gradually increase if nothing is done about it:
- a feeling that the bladder never completely empties;
- a desire to pass urine much more frequently;
- waking at night to pass urine (nocturia);
- difficulty in getting started when urinating (hesitancy);
- pain when passing urine or blood in the urine;
- poor flow of urine.
Orthodox treatment of this condition is with drugs in milder cases and surgery in more severe cases. The main drug used is finasteride, which can sometimes slow down the enlargement of the prostate. There are two types of surgical operations for BPH: removal of the prostate or boring a hole in it to ease the flow of urine, an operation known as a transurethral resection or TUR. The drugs can of course have side effects and the surgery almost always has a downside. Removal of the prostate prevents normal ejaculation and can result in impotence, especially in older men. TUR usually does not affect potency but often results in retrograde ejaculation (into the bladder instead of out through the penis), which obviously has an effect on a man’s sex life. However I believe that homeopathy has a big role to play in the treatment of prostatic enlargement.
The homeopathic medicine Sabal serrulata is an excellent and specific treatment for BPH. When I first studied homeopathy a quarter of a century ago, Sabal had been used for many years for this condition. It was also used by herbalists who knew it by the name saw palmetto or serenoa repens. Native Americans have been using the berries of this plant for urinary tract problems for many centuries. It also once had a good reputation as an aphrodisiac but alas no more! The early American homeopaths of whom many were “eclectic” physicians had knowledge of the world of herbs and quickly included Sabal serrulata into the homeopathic materia medica, where clinical experience made it the most well-known specific homeopathic remedy for BPH. At the Royal London Homoeopathic Hospital I was taught to use it in mother tincture rather than in potency. As results have been rather good with this form of the remedy, I have never changed although I have heard of homeopaths getting good results with various potencies.
After making a diagnosis of BPH, I take a full homeopathic history in the usual classical way. My aim is to find a remedy that suits his constitution and prescribe this remedy in a high potency as well as Sabal serrulata in mother tincture. So a typical case may receive Lycopodium 200c three doses in the first 24 hours followed by six drops of Sabal serrulata mother tincture three times a day. Such an approach is consistent with the French homeopathic methodology known as “drainage”. I am a classical homeopath and don’t use this approach routinely at all; in fact Sabal serrulata is one of the few homeopathic remedies I prescribe in this way.
The herbal form of Sabal serrulata, saw palmetto, has been shown to be at least as effective as finasteride in several properly controlled clinical trials. Most impressively a meta-analysis (analysis of several trials) of the same herb strongly suggests that this medicine is definitely of use in the treatment of BPH. I am inspired by the fact that a remedy that has been used by homeopaths for over a century for prostate problems has only recently been scientifically proved to be useful for BPH. Inspiring but not particularly surprising; homeopaths have been convinced of its efficacy in this condition for a very long time.
Brian Kaplan MBBCh FFHom has practised as a homeopathic doctor for over 20 years. In 2001 he published the critically acclaimed The Homeopathic Conversation. He was elected as a Fellow of the Faculty of Homeopathy in 2002. His website is www.drkaplan.co.uk