1. Urinary Antiseptics and Demulcents

2. Arctostaphylos Uva Ursi

3. Arctostaphylos uva-ursi

4. Arctostaphylos uva ursi

5. Arctostaphylos Uva-Ursi
Arctostaphylos, from the Greek, 'arktos (arktos), "bear”, stafulh (staphyle), "grapes"
uva-ursi, from the Latin uva, "grape, berry of the vine", ursi, bear; "bear's grape"
Uva-Ursi, Kinnikinnick, Crowberry, Foxberry, Mealberry, Mountain Box, Mountain Cranberry , Upland Cranberry.

6. Arctostaphylos Uva-Ursi
Family: Ericaceae
Grows throughout the Western foothills and mountains, from California through Alaska
Part used: Leaves
Qualities: Dry, astringent, cold

7. Arctostaphylos Uva-Ursi
Constituents: hydroquinone glycosides (4-15%): arbutin, methylarbutin
polypheneols , tannin (increased in older leaves),
Flavonoids (quercetin),
Acids (ursolic, gallic, ellagic),
Allantoin,
Volatile oil: lupeol

8. Arctostaphylos Uva-Ursi
Standardized extract; 70 mg arbutin: two 0.7 g tabs BID-TID. ; hydroquinone derivatives calculated as water-free arbutin.
Tincture: 1:5 tincture: ml qd; 1: ml TID
Infusion: 2-3 tsps/ cup boiling water. Drink 1 cup qid. [because the Ericaea leaves are tough, sometimes its helpful to do a modified version, simmering for a couple of minutes.

9. Vaccinium macrocarpon

10. Vaccinium macrocarpon

11. Vaccinium macrocarpon
Common name: Cranberry
Family Ericacea
Part used: Berry, juice of berry
Constituents: hippuric acid, Proanthocyanadins, Vitamin C
Cranberries contain proanthocyanidins (PACs) that can prevent the adhesion of bacteria to the urinary tract wall. The anti-adhesion properties of cranberry may also inhibit the bacteria associated with gum disease and stomach ulcers.
Important note: the mechanism of action is not due to acidification of the urine.

12. “Impact of cranberry on Escherichia coli cellular surface characteristics. “
“The anti-adhesive effects of cranberry have been attributed to both interactions of its components with the surface of bacterial cells and to inhibition of p-fimbriae expression…Here, we show that the morphology of E. coli is changed when grown in the presence of juice or extract from Vaccinium macrocarpon (cranberry). Gene expression analysis indicates the down regulation of flagellar basal body rod and motor proteins.”
Johnson BJ, Lin B, Dinderman MA, Rubin RA, Malanoski AP, Ligler FS. Biochem Biophys Res Commun Dec 19;377(3): Epub 2008 Oct 26.

13. Vaccinium macrocarpon
Medicinal action: Bacteriostatic
Medicinal uses: Acute urinary tract infection
Contraindications: It has no known toxicity, and appears to be safe in pregnancy and lactation.

14. Vaccinium macrocarpon
Dosing:
Standardized extract mg TID
Tincture (1:4): ½ tsp tid-qid
Non-etandardized encapsulated products vary widely in strength, and relative dose recommendations (usually around 5000 mg qd of fresh cranberry equivalent or 1500 mg qd cranberry juice equivalent)..
Fresh cranberry juice 0.5 L/day. It is important to note that this needs to be pure cranberry juice that is sugar free. .. or is it so important?

15. Chimaphila umbellata

16. Chimaphila umbellata
Common names: Pipsissewa, Prince’s Pine, Winter Green (not the same as Gaultheria procumbens)
Family: Ericaceae
Part used: Herba
Grows locally and throughout the temperate regions.
Constituents: Arbutin, chimaphillin, methyl salycilate, tannins.
Actions: Astringent, antimicrobial (arbutin), tonifying, diuretic
Indications: Acute urinary tract infections

17. Chimaphila umbellata Dosing: Tincture: 2.5-5 ml BID-QID
Infusion:2-3 tsps/ cup boiling water. Steep 5-10 minutes. Drink 1 cup 3-5x per day

18. (Barosma betulina) Agathosma betulina

19. Agathosma betulina Common name: Buchu Family: Rutaceae
Part used: Leaves
Native to South Africa
Volatile oil (2%): diosphenol (=buchu camphor), pulegone, (+) and (-) isopulegone, 8-mercapto-p-menthan-3-one, 8-acetylthiomenthone, piperitone epoxide (+)-menthone, isomenthone, p-cymol, limonene, terpineol
Flavonoids: rutin, diosmin, hesperidin, quercitin and derivatives
Miscellaneous; B-vitamins, tannin and mucilage.

20. Agathosma betulina
Medicinal Action: Urinary antiseptic, stimulating diuretic, diaphoretic
It also has some nervine action, and can be used when there is anxiety accompanying urinary inflammation.
Dosing:
Dried leaf: 3-6 g qd
Tincture (1:2) 1-2 ml BID, (1:5) tincture: ml BID
Infusion: 1-3 tsp/cup water infused for 10 min, 1 cup TID

21. Agropyron or Elymus repens

22. Agropyron or Elymus or Elytrigia repens

23. Agropyron repens Constituents: Common name: Quack Grass, Couchgrass
Family: Graminaceae
Distribution: A common pest plant in temperate regions. “Invades” lawns and landscapes
Constituents:
Saponins
Carbohydrates (3-8% triticin polysaccharide, 2-3% inositol and mannitol, 10% mucilage)
Volatile oil (agroyprene), fixed oil
 carotene, Minerals (silica, iron, potassium), Silicic acid and silicates

24. Agropyron repens Medicinal action
A saponin and carbohydrate (mannitol) based diuretic
Demulcent
Antimicrobial
Expectorant

25. Agropyron repens Decoction: Tincture (1:5 25%): 3-6 ml tid
2 tsp/cup water. Bring to boil, simmer x 10 min. Drink TID.
Tincture (1:5 25%): 3-6 ml tid
No toxicity or contraindications

26. Zea mays

27. Zea Mays (Maydis stigmata)
Common name: Cornsilk
Family: Graminaceae/Poaceae
Part used: Flower Pistils
Saponins, allantoin, sterols (beta-sitosterol, stigmasterol ), alkaloid (hordenine), vit. C, vit. K, potassium, carbohydrates including mucilage; cryptoxanthin, anthocyanins, plant acids, fixed oil (2%), essential oil (0.1%): carvacrol, terpenes, bitter compounds, polyphenols (12%), potassium salts

28. Zea Mays (Maydis stigmata)
Acute: 2-4 g/day; infused in 1-2 Qt/day or 1 cup every hour [1tsp. = 0.5g]
Best as a cold infusion.
Tincture (1:5 25%): ml /day

29. Parietaria judiaca

30. Parietaria judiaca Family: Urticaceae Name: Pellitory-of-the-wall
“Pariet” or “pared” means “wall”
Used to be called P. officinalis, and there is still controversy over whether p. judiaca is the same species or slightly different from P. judiaca.
Pollen is highly allergenic and sticky; plant often called “sticky weed”

31. Parietaria judiaca Diuretic and demulcent
High in flavonoids and potassium
Most useful for inflammatory conditions of the kidney or bladder
Nephritis
Cystitis
Considered a trophorestorative to the kidneys
“Sylibum of the Kidney”

32. Parietaria judiaca

33. Case 1
63 year old woman with an extensive history of recurrent cystitis treated using antibiotics.
Had “bladder lift” surgery 5 years ago to correct a malformed urethra and prolapsed uterus. The UTI’s did not stop, and she suffered extensive nerve damage.
She must self-catheterize to void her bladder if it fills past a certain point. She takes prophylactic antibiotics, which affects her digestion and promotes yeast infections.
Also a long history of anti-anxiety, anti-depressant, and sedative medications x 40+ years.

34. At this point she seeks help from a naturopath, since the medical help she has gotten so far has only made things worse over the years.
What can we do for her?

35. Urinary Formula Arctostaphylos uva ursi 2 parts
Agathosma betulinum 2 parts
Achillea millefolium 1 part
Elymus repens parts
Parietaria judiaca 2 parts
Zea mays part
Infusion – one tablespoon per cup. 4 cups per day. Sweeten with mannose.
Also drink 8 oz. cranberry or blueberry juice per day.

36. Other treatment considerations
Exercises for strengthening the pelvic floor muscles.
Gradually work toward discontinuing the anxiety/depression/sleep meds
Use diet and supplementation to support healthy brain chemistry
Regular counseling
Probiotics, bitters, astringents to restore digestive health
Vaginal suppositories to restore normal pH and flora
Boric acid, Hydrastis, vitamins A & E, Acidophillus

37. REMEMBER…
Dr. King’s birthday next week… No class!!