The Art of Treating Chronic Diseases
Preface       List of Cured Cases       
Treating chronic diseases is just like building a castle i.e. placing one brick over another. This is a process and in this process every step has its own significance, but the most important step for a strong castle is its foundation; similar is the case in homoeopathy, case history is the foundation on which " Cure" stands. To achieve our aim i.e. cure a correct case history is of utmost importance. I will explain my point by giving you an example – Suppose a patient came to us with the following symptoms
1. Excessive bleeding during menses.
2. Aggravated by motion.
3. Violent irritation of bladder.
Erigeron came out as a drug of choice, but we forget to ask how the complaint started. On enquiring we found out that bleeding started after lifting bucket full of water, now instead of Erigeron, Calcarea carb is the drug of choice. This proves two point's-
1. Complete detailed case history of the patient is very important in selecting correct remedy for speedy recovery.
2. Finding the cause and giving corresponding medicine is necessary for quick relief.
Once we have the correct case history of the patient, the second problem that comes in front of us i.e. what to do with the case. In a particular case we have to find the following things –
1. Epicenter of all the disturbances i.e. cause of the disease.
2. Uncommon and peculiar symptoms.
3. Other symptoms with concomitants.
4. Family history.
5. Past history.
6. Side effect of drugs used.
7. Ill effect of vaccination.
We can achieve the totality of the case by keeping in mind all these important points. Medicine is then prescribed on this totality. Each point is elaborately dealt with later.
Generally treating a chronic disease is not like a hundred meter dash. Treating a chronic disease is just like catching a hen in an open felid that does not run in a straight course. So, is the case with chronic disease; once you give a medicine selected on the totality of the symptoms, it may give you desired result for a certain period of time. After some times the medicine stops giving you the desired result. Now at this point we have three choice's one is to increase the potency of the medicine, if the patient is presenting the same symptoms or a new medicine has to be given if there is any change in symptoms or we can give an inter-current medicine if required according to the family history or the past history of the patient. At this point of time it is the skill of the physician to select the path, which is best suited for the patient for his/her speedy and gentle cure. The process is continued till our final aim i.e. cure is achieved.
Once we have selected the correct medicine, then the next problem, which appears before us is "the selection of potency". There is great deal of confusion regarding the selection of potency. Some doctors advocate use of high potencies and some of low potencies. We are not commenting any thing on any body, but we will tell you what we are doing regarding selection of potencies for the past three generation. In chronic cases generally (90% of the cases) we start with 200 potency once a week and continue the medicine in the same potency unless and until it stops acting. Once the medicine stops working and the patient is presenting the same symptoms, then we raise the potency to 1000. Generally we repeat 1M after fifteen days and 10M after one month. Here we will like to add one more thing, selection of potency depends upon condition of the patient and may vary from patient to patient. Now, we will tell you the instances where we have repeated the medicine in a different manner. We were treating a cancerous patient in her last days. Patient complained of restlessness and burning with increased thirst for cold water, so we gave her Phosphorus 200. The next day her son told us that the patient is feeling better, so we decided not to repeat the medicine as it is not advisable to repeat 200 potency, that too a metallic medicine before a week. The next day her son told us that the patient's problem is again aggravated. On enquiring about the symptoms we found out that there was no change in symptoms and she is presenting the same symptoms. So, at this point we have got two options, either to increase the potency of the medicine (give phosphorus 1M) or to repeat the medicine in 200 potency. We decided to do the later. The reason for not giving 1M potency was that the patient was very weak and we fear that giving high potency could be fatal. Giving high potency to a weak patient is just like putting a hundred kilogram weight on the chest of a weak person. Next day her son told her that she slept the whole night and she is feeling better. Phosphorus 200 was repeated daily for about a week after that it was given after two days then after four days and finally after a week. After a month of treatment patient complained of increase in intensity of her complaint, so Phosphorus 200 was repeated daily for two days but to no effect. At this point we decided to give Phosphorus 200. Now we will tell you another case where we have repeated high potency daily. A two years old child by mistake took Kayam Churn (a very strong drug used by person suffering from chronic constipation). We gave Nux Vomica 200 two doses at fifteen minutes interval. The next day his mother came and said that there is no change in condition of the patient. Keeping in mind the strength of Kyam churn and what it does to the peristaltic movement of the intestine we decided to give Nux Vomica 200 four globules in half a cup of water four times a day. The next day her mother informed us that his stool is normal. These are just two instances where we have repeated two hundred potency before a week. Here we will like to add a note of caution "Take ultimate Precaution while giving high potency that often as it is very dangerous and it may cause unnecessary drug aggravation."
Once we have selected the medicine and its potency, then its time to select the quantity of medicine to be administered to the patient. Generally we can give one globule of zero number to twenty globules of sixty number, it will act as one dose, but it is advisable to give one to two globule of twenty number in one dose as it will prevent unnecessary aggravation of the medicine, especially in hyper sensitive patient. I will explain it to you by giving you a true instance that happened a very long time back. A hyper sensitive patient came to my grand father late Dr. P. N. Shangloo in early seventies. My grand father asked my father Dr. G.K.Shangloo (who was a first year student at that time) to give two globules of zero number as one dose but by mistake the assistant gave ten globules. The very next day patient came running to my grand father stating the all his complaints are aggravated. On enquiring he found out that there was only increased in intensity of his previous symptoms. He consoled the patient " don't worry you will get relief very soon". Once the patient has gone, my grand father said "Start your experience from here, this patient was a hyper sensitive patient and the aggravation you are seeing is because of excess quantity of medicine. So be careful with the quantity of medicine when you are treating a hyper sensitive patient.
Before we conclude, we will like to say one more thing, treating a chronic case is an art and it is the skill and will of the doctor that guides him to his/her final destination i.e. Cure.

Role of Homoeopathy in uterine fibroid and ovarian cyst treatment
Dr. G.K.Shangloo,  Dr. Sharad Shangloo,  Dr. Sunit Shangloo
Meera Shangloo Homoeopathic Research center
70/59 Rani Mandi Allahabad U.P India 211003
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OBJECTIVE: To establish the positive role of Homoeopathy in curing surgical diseases like uterine fibroid and ovarian cyst through homoeopathic medicine at the general practice in Allahabad India.
MATERIAL AND METHODS: The well-proven Homeopathic medicines were selected on the basis of principles of homeopathy to the patients of uterine fibroid and ovarian cyst during the period of 1996 to 2004.  The patients were assessed on the basis changes in the symptoms during the period of 3-4 months and Ultrasound done after that to Asses the size of fibroid.
RESULTS:  Statistical Data of patients cured by us:1996-2004
No. Of Patients entered- 123
No. Of patients who followed the protocol-100
No. Of patients which improved-85
No. Of patients with complete removal of fibroid 48
NO. Of patients whose size reduced but no complete removal-20
Success rate Cure-48%
Rate of Response to Homoeopathy- 85%
CONCLUSIONS: Homeopathy is becoming increasingly popular in whole of the world. Now it is time to prove to the world what homeopathy can offer in surgical diseases. Homeopathic medicines cannot take the place of surgery but can be of great help to the patients, which do not want to go for surgery or cannot be operated upon due to various medical reasons. It is also ideal for underdeveloped and developing countries where financial factor play a major role in deciding the options for treatment.

Homeopathic Cure to Uterine fibroid and Ovarian cyst 
Dr. G.K.Shangloo,  Dr. Sharad Shangloo,  Dr. Sunit Shangloo
Meera Shangloo Homeopathic Research
70/59, Rani Mandi, Allahabad.

The cases we had selected for presentation covers the various modes of prescribing according to the laws of homoeopathy.
Miasmatic Approach - Generally fibroids and cysts are sycotic in nature.
Homoeopathic approach to the treatment of Uterine Fibroid and Ovarian cyst:
In homoeopathy we believe that vital force is the most important and the governing constituent of the human being. If the vital force is deranged then only the person is sick. Vital force is intelligent .It is evident that when man’s vital force is encumbered with chronic disease adopts a plan. The plan is of developing a local malady on external part i.e the least important part solely for the object to there by silence the internal disease, which other wise threatens to destroy the vital organs. The vital force or the force that pervades the cells has its own intelligence. It is only because of its intelligence that the cell and the tissue recognize hat it harmful to it, what belongs to internal environment and what does not. What primary steps to be taken like psychological defense response; when to change the physiological defense to morphological defense. What to produce, what to accumulate in excess or what to produce lesser which organ or tissue to destroy. It is because of intelligence it knows which is the least important organ for example skin and above all it is this very intelligence which induces the body to produce pain, sensitivity,or a growth or an ulcer so that it can draw attention of outsiders and to  make it known that all is not well within.
Miasm have clear mentals. In sycotic minds there is impending fear of being finished or destroyed. There is false projection of exterior not reflecting the interior is a part of shrewd, shy, maneuvering tack ticks .The whole mentality is based on selfish motives and gratification of urges. Thus cowardice, fragility, fears, hiding cover-up, projections, facade, thick skinned, hoarding, accumlation of money, treasures, show man ship, cunningness, slyness, shrewdness, maneuvering, political shamelessness, self centered are some of the rubrics which can describe the sycotic mentality.
Here we also have to understand weather the patient has a sycotic mentality or not. If yes we have to understand weather it is of sycotic excess or less
In sycosis excess person indulging in over expression and over projection. These were applied to expression, will, intellect, emotions, morals, etc. will give us a sycotic excess trait. Thus sycotic excess has traits like loquacious, dictator, profuseness of thoughts, over expressive and intelligent. Quick perception, theorizing, high achiever, slyness and non-conscientiousness.
Modern religious gurus, politicians fit very well into this description. They indulge in aberration departure from what is true right and correct.
In sycosis less there is under use of   intellect, under willed, under expressed and under growth of intellect. Thus in such persons adaptability is conspicuously lacking. There is under expression of one self, talk indisposed to, secretive, reserved, under expression of will. Sycosis less people compromise easily, they recognize but do not move. They are quiet, reserved, introverts, desireing obscurity and solitude. And suffer from indigestion.
Behaviors pattern in sycosis excess is exaggeration, or expression, deceitfulness, slyness, show off or false show pseudoism.
The significance of determining the dominant miasm helps us to determine the similimum. Even though the symptoms will indicate an appropriate remedy but  for permanent dissolution of fibroid or ovarian cyst a miasmatic remedy is required as a main remedy or as an undercurrent remedy.
Every individual defends according to his underlying miasm. All the emotions and intellect are defensively oriented and evolved. Thus various traits of an individual will reflect the miasm ruling her at that stage. The reaction to situation will be completely different in different miasms because the defensive method is different.
Hahnemann states that miasm is the root of all diseases. Mordern pathology also confirms that cell defense response is of three types .Hahnemann description if itch as psora,fig warts as sycosis  and chancre as syphilis matches with the three basic defense of cell psychological defense, i.e. psora, constructive defense i.e. sycosis and destructive defense i.e. syphilis.
1. Individualistic.
2. Symptomatic
3. Rare uncommon Peculiar Symptoms
4. Reportorial
5. Causative
How to take case of the Patient:
Case taking is the most important part in the prescription for the case. The case should be taken by the unprudigist mind. No medicine or a group of medicine should be presumed to be given on just the name of disease.
The body of an individual has the defense mechanism of its own. The defense has a genetic code and the genetic code decides the reactions of an individual to an action. You have to be very cautious while writing the reactions of that case.
The reactons are of two types:-
1. Physical reactions.
2. Mental reactions
Physical Reactions:-
The tolerance and intolerance to various stimuli like sun, wind, rains, damp, cold, heat, noises, colors, touch, emotions, decides how the concerned individual should react in different circumstances. These reactions to the situations i.e general make –up of an individual are basically defense mechanism at work and hence defense oriented. These are influenced by genetic code.
Mental Reactions:-
These reactions solely depend on the intelligence of the individual .The intellect, will moral, moral, etc. allows the person to react according to the needs and circumstances to form a defense. The innate character of the reactive mechanism, the attitudes, defenses together with susceptibility make up mental aspect of the individual, which in turn is governed by the genetic code of the individual.  
Disease pathologies are due to three defense mechanism at work. Like all the properties of the cell, even the three defense responses to stimuli are genetically governed. Weather the cell should inflame, indurate or ulcerate depends on the genetic code character of the cell. The physical makeup, the mental makeup,the general make up and the disease susceptibility of an individual depends upon defense .These make ups are arising from the genetic code and are genetically governed.
The whole genetic setup of an individual is designed to ensure that the mind, physique, tolerance, likes, dislikes, as well as susceptibility to diseases aredesigned for prolonged survival of an individual.
Points on which the emphasis should be given while case taking:
1. Character of pain is most important of they are there. Like weather it comes suddenly, or gradually. How does it subsides or decreases.
2. Other thing which has to paid heeds to is that how one gets relief in pain. Here along with the physical modalities thermal modalities are most important. According to whein and Tyler.
3. Character of bleeding and color and texture of blood and clots.
4. Mental state of the patient. Especially if there is prolonged mental stress they act as obstacles of cure.
5. Past history of the patient. It helps us to clear the case in many ways.
6. Family history of the patient Generally of –Tuberculosis, Cancer Arthritis, Asthma, Diabetes. Etc.
7. Miasmatic Constitution of the patient:-
We should group the patient in dominating miasmatic tendencies. Fibroid and cysts are generally sycotic in nature. Sycotic constitution has an innate and predominant tendency to fight all the invasions weather they are pathogens, toxins or on the mental plane i.e  emotions by constructive defense responses of the cells and the tissue. These people are bound to get easy growths thickenings,tumors and chronic non-resolving inflammations.
Insidious diseases like diabetes, hypertension, anemia, hyperlipidaemias, ischaemias, are common at the early age. Warts,moles, keloids throw up externally give us an indication that the patient has entered the sycotic defense stage.
Patients get primary inflammations and go into constructive pathology easily. Wounds and injuries are deceptive, never clean cut  nor do they heal neatly and clearly .They are deep inside and concealed with yellow or green coloured discharges. Deposition of pigments hence blackening of skin or wound is a rule to this miasm.
So, there can be two forms of it:
A. Sycosis excess
B. Sycosis low
Uterine fibroids, ovaran cysts are due to high sycosis.
7. Miasms have clear mental:-
We have to search for the dominating miasm in the patient and this can be done by studying the mental aspect of the patients. On your patient you can go into his dominant miasm not only by physical features but also having an idea about his mental symptoms.
In sycotic mental you will find that there is impending fear of being finished or destroyed. There
Parameters of Layers of a case:
Constitution Miasm Fundamental Pathologies
Temperament psora personality trauma
Body type Sycosis mind toxic
Genitic Syhilis emotions  
  Cancer generals tissue
  tuberculosis particulars organ
  Vaccinations Life style causation
  Plague etiology infection
  Malaria state disease
Here I would like to clarify that I am not contradicting the three miasm theory of Dr. Smuel Hahanemann . But I had put cancer, tuberculosis, vaccinations, plague, malaria, typhoid, under miasm because they also have a long lasting effect and a the intercurrent medicine has to be given accordingly if required in the case.
Case Analysis:
Case analysis is not symptom analysis. No symptom in any case stands alone. Symptoms flow from a source.  Suppose for example a person has pain in leg and due to that he is very depressed and there is loss of sleep. So, In this case the medicine will be given for the pain in leg not for insomnia because the pain in leg is the source or the cause. But in case of other patient who is suffering from gastric complaints and is very irritable and due to increased suppressed anger he gets a gastric ulcer. The medicine will be prescribed for gastric ulcer.
Different levels of case analysis:
There are seven  different levels of case analysis :
1.   Psychology – It includes Mentals, emotional, cultural and social state of the patient.
2.   Vitality – Vital leaks, blockage of vital energy, susceptibilities, weakness.
3.   Causation – Images, time line, stories, medical history
4.   Clinical
5.   Different layers of case :In any chronic case
      a.  Constitutional
      b.  Miasmatic
      c.  Fundamental
      d.  Pathological
6.   Symptoms –The symptoms help us to confirm the remedy.
7.   Perceiving  the case.
Perceiving the case :
 A. In Homeopathy we must perceive what has to be cured in the case. In every case there is a cause due to which there is a change in state of health, which produces symptoms.
B.  In every case you ask your self what is most important in case?
Suppose there is a dam and due to the leakage the water is flowing from it you can not repair the leakage just be seeing the flow of water. You have to find out the leakage point in the dam.
Suppose a lady has a menopause after child birth and she is never well since the,. She is producing all kinds of symptoms like irritating. Flushes of heat, depression. Loss of sleep, the remedy that we would like to select will be post partal antidepressant remedy. I.e a remedy, which in repertorisatin should cover basic rubrics ailments caused from suppressed menses or menopause.
C. Symptom Analysis;
Common mistake of analyzing the symptoms separately, by predetermined hierarchies, or analyzing symptoms numerically is not the correct method.
Symptom analysis is not case analysis
The remedy, which covers all the cause then few changes in the change in state of health only few symptoms, is the perfect selected remedy.
On the contrary the remedy, which covers all the symptoms but does not covers the cause and the change in state of health will do no good.
The importance of the symptom should be determined by analyzing its place in a particular case.
Understand the structure of the individual case:
By understanding the structure of the case helps us what to repertorise.
D. Chief complaints;- At times suppose the women is suffering from intense pain the medicine had to be given on the chief complaint first.
E. Cause and Etiology:
We always say in homoeopathy we treat the cause but not he symptoms. But hw to find the cause.
The cause can be found in different cases in any of the following heads.
1. Mental or emotional stress or shock
2. Infection from some diseases. Like never will since typhoid, pneumonia, jaundice, suppressed skin affections.
3. Physical trauma- injury after, profuse bleeding after.
4. Toxic exposures – Suppose a lady painted her house 2 days back lead to pain in abdomen and the symptoms totally resembled colocynth. But it gave no relief. We all know that pain contains high amount of lead . Plumbum met cured the case.
5. Vitality factors- Suppose a lady with fibroid and ovarian cyst has a husband  the husband is suffering for terminal stage of cancer. The wife serves the husband day and night. This cause loss of her vitality due to loss of sleep and over strain. 
IF a women after profuse bleeding the remedy is for the blood.
6. Excess or deficiency of any thing
7. Miasmatic factor
8. Diet and nutritional factors
9. Life style
10. Medical intervention
11. Hygiene factors
F. Sorting out layers in a case.—Draw the time lines which thing happened first  It is governed by the Hering’s law of cure. 
G. What are the vital layers?
Like the tree has annual rings .Some are thin, some are thick depicting the weather and environmental factors of that year. So is the case with the disease also.
In the human body there are four different types of layers:
1. constitutional
2. Miasmatic
3. Fundamental
4. Pathological
Each layer has susceptibility and each layer has symptoms.
Clinical or pathological layer
Fundamental Layer
Miasmatic Layer
How to select a Remedy:
1. by assessing which symptom to be given importance when
In homeopathy, much emphasis is given on mind. So, some doctors who try to collect tiniest o f the tiny mental symptoms. For them Dr.Kent had given a warning – Just because the homeopathic physician knows that mental symptoms are most important he should not hunt for it in the hay sack for a tiny mental to open up his case. All the symptoms should have same importance as assigned to them as symptoms.
2. Elimination of useless symptoms
Many a times it happens that the remedy that we select after complete repertorisation or after assessing the rare uncommon peculiar symptoms does not match all the symptoms recorded in a particular case.
Here also one should keep in mind Dr.Kent’s saying –
Do not expect the remedy that has the generals should have all the little symptoms. If the remedy has the generals it is sufficient to prescribe for a case.
Kent says nothing disturbs me much as the long letters I get from the doctors showing me how they had wasted time on useless particulars. Common particulars are generally worthless.
3. Elimination of Medicines after Repertorisation-
On the basis of thermal modalities
The British school of Homeopathy headed by Tyler and Sir John Weir advocated to first taking most characteristic symptoms carefully followed by separating medicines in hot and chilly type.
In chilly patients medicines<warmth are eliminated
In hot patients medicines < cold are eliminated.
Hence resulting in the similimum.
4. Selecting Remedy without repertorisation on the basis rare uncommon peculiar symptom
This is one of the many modes of prescribing for a particular case. In this Allen’s Keynotes are of great help. Here two or three rare uncommon peculiar symptoms are sufficient are enough to prescribe for a case. Here patient should verify the rare uncommon and peculiar symptom again and again before prescribing on it.

5. Selecting intercurrent remedy on the basis of past history of patient
At times it happens that a well-selected remedy after complete repertorisation fails to provide complete cure to the patient. When the patient is also adhering to the diet and regime advised by us. This is because there are few obstacles in cure. Many learned physicians had described these obstacles. In case of fibroid and ovarian cyst it is found that past history, family history and causative factors acts as obstacles of cure.
Preface       List of Cured Cases