Simply mix two teaspoonfuls of household tablesalt in I litre of water and chill the solution to 13-15 degrees Celsius (55-60 degrees Fahrenheit). Bedtime is the best time for carrying out the following simple procedure: Sit upright on the toilet. Introduce about 125 ml (about 4 oz) of the cold saline solution into the rectum through the rectal tip of an enema kit; retain the fluid for about 40 seconds and then expel. After one and a half minutes, repeat the procedure, and continue for about eight irrigations, which would use up the saline. Make sure that the salt water is not too cold or don't keep it too long in the rectum. Do the irrigation three times per week, reducing the frequency as you get better (QM Hoag, et al, Osteopathic Medicine, New York & London: McGraw-Hill, 1969).

For 75 years, homoeopaths have very successfully used remedies made from the herb saw palmetto, called Sabal serrulata, in low potencies, or as a mother tincture (W Boericke, Pocket Manual of Homoeopathic Materia Medica, Boericke & Runyon, 1927). In a number of studies of this remedy, quantity of urinary flow and prostate size substantially improved (Rozhl Chir, 1993, 72(2): 75-79).

Pygaeum africanum, the extract of the bark of a tropical African evergreen tree, has been widely used in herbal medicine. In an experimental double-blind study in Austria, those receiving 50 mg of this herbal extract twice daily for 60 days showed a significant improvement. Five patients had gastrointestinal side effects, causing two to discontinue treatment (Wien Klin Wochenschr, 1990, 102(22): 667-673).

Although highly useful, this herb is not as safe or as effective as saw palmetto. In one study, patients given Sabal serrulata showed a greater decrease in symptoms and a greater increase in urine volume than the group on Pygaeum africanum. Although Sabal serrulata had no side effects, Pygaeum africanum caused unpleasant gastric symptoms in 13 per cent (R Duvia et al, Advances in the Phytotherapy of Prostatic Hypertrophy, Mediz Praxis, 1983).

German herbalists often prescribe the roots of stinging nettles (Urtica dioica) for BPH - and with good reason. Testosterone levels decrease with age after 50, while 'female' hormones such as estradiol are increased. There is a potent androgen derived from testosterone called dihydrotestosterone (DHT). Both male hormones are normally metabolized through hydroxylation. But estradiol, which is now more plentiful, inhibits this process of hydroxylation and the end effect is a greater concentration of DHT in the prostate, which is thought to be the reason for prostate enlargement. Studies have found that the extract beneficially influences the binding of DHT (Fortschr Med, 1983, 101(15): 713-716).

For more than 35 years, flower pollen has been successfully used in Sweden to treat BPH. As pollen is the plant equivalent of the male fertilizing element, it is probable that the beneficial effect is due to plant hormones. Five successful studies have been reported (Br J Urol, 1990, 66(4): 398-404).