Physiology and Biochemistry in the First Year — how the body works

If anatomy teaches where things are, physiology teaches what they do — and biochemistry teaches the chemistry by which they do it. Physiology and Biochemistry, HomUG-PB in the NCH curriculum, is the First Professional subject that turns the structural body of the anatomy hall into a living, working one. For a homoeopathic student it has a particular importance: the Organon’s concepts of health and disease, and the materia medica’s descriptions of functional change, both assume a reader who knows what normal function looks like.

The CBDC course content runs to fourteen chapters. They can be read as four groups.

**The general foundations.** General Physiology opens at the level of the cell: cellular physiology, cell junctions, transport across the cell membrane and the resting membrane potential, the body’s fluid compartments, and homeostasis — the idea of a stable internal environment that the rest of the subject keeps returning to. Bio-Physical Sciences then gathers the physical processes physiology depends on: filtration and ultra-filtration, osmosis and diffusion, adsorption, hydrotropy, colloids, the Donnan equilibrium, tracer elements, dialysis, absorption, assimilation and surface tension.

**Blood, immunity, nerve and muscle.** The chapter on Body Fluid and Immune Mechanism is one of the longest: blood and plasma proteins, red cells and erythropoiesis, haemoglobin and iron metabolism, the sedimentation rate, packed cell volume and blood indices, haemolysis and fragility, white cells and immunity, platelets, haemostasis and coagulation, blood groups, transfusion and blood volume, the reticulo-endothelial system and tissue macrophages, lymph, and tissue fluid and oedema. Nerve Muscle Physiology studies the properties and classes of nerve fibres, their degeneration and regeneration, the neuromuscular junction, the physiology of skeletal, cardiac and smooth muscle, and electromyography. Skin and the Integumentary System covers the layers and functions of skin, sweat, and the regulation of body temperature.

**The organ systems.** The Cardio-Vascular chapter covers the properties of cardiac muscle, the cardiac cycle, the principles of circulation, heart sounds, regulation, the normal and abnormal electrocardiogram, cardiac output, heart rate, arterial blood pressure, the radial pulse, regional circulations, and the adjustments of exercise. The Respiratory chapter covers ventilation and gas diffusion, the transport of gases, the regulation of breathing, pulmonary function tests, and environmental physiology — high altitude and space, deep sea — with artificial respiration and the effects of exercise.

The Central Nervous System chapter is the widest of all: neuron and neuroglia, receptors, synapse and neurotransmitters, reflexes and the spinal cord, the somatosensory and somatomotor systems, the physiology of pain, the brain stem and vestibular apparatus, cortex, thalamus, hypothalamus, internal capsule, basal ganglia, limbic system, cerebellum and posture, reticular formation, proprioception, higher intellectual function, the EEG, the physiology of sleep, cerebrospinal fluid, and the autonomic nervous system.

Endocrinology opens with the importance of the PNEI axis and the hypothalamo-hypophyseal axis before taking the glands one by one. The Reproductive System chapter covers male and female reproductive physiology, the menstrual cycle, ovulation and menopause, fertility and infertility, pregnancy, parturition and the placenta, pregnancy tests, lactation and foetal circulation. Special Senses covers vision, hearing, taste, smell and touch through their receptors and pathways. Digestive System and Nutrition studies the digestive juices, the physiological anatomy of the gut and its glands, gastrointestinal movements and hormones, and the digestion and absorption of carbohydrates, proteins and lipids. Renal Physiology covers urine formation in detail — clearance, glomerular filtration, tubular reabsorption and secretion, concentration and acidification — together with fluid, electrolyte and acid-base balance, renal function tests and micturition.

**Biochemistry.** The final chapter is the biochemistry theory of the year: carbohydrates with glycolysis, the TCA cycle, the HMP pathway, glycogen metabolism and blood glucose regulation; lipids with their transport, beta oxidation and fatty-acid synthesis; proteins with transamination, deamination, the fate of ammonia and the urea cycle; enzymes, their classification, diagnostic use and inhibition; vitamins and minerals with their daily requirements, dietary sources, disorders and physiological roles; and organ function tests.

The subject’s reach beyond itself is written into the curriculum. The Repertory syllabus asks students to find the chapters and rubrics of Kent’s Repertory that relate to physiology. The Psychology syllabus builds on the physiological basis of behaviour. Pharmacy has a chapter on its relation to physiology. The PNEI axis named in endocrinology is a meeting point between this subject and the homoeopathic interest in the whole person.

As this room fills, a student will find pieces written to this syllabus: system-by-system orientations, careful explanations of the mechanisms students most need to see drawn out — the cardiac cycle, urine formation, the metabolic pathways — and pieces that show where a physiological concept surfaces in the Organon, the repertory or the psychology course. Everything here carries the first-year tag and the Physiology and Biochemistry category. The room is filling steadily, in the order the syllabus sets.