Gynaecology and Obstetrics in the Second Year — two units, one frame

Gynaecology and Obstetrics is one of the three clinical subjects that begin in the Second Professional year of BHMS, and like Surgery it is taught in two parts, the second following in the third year. The first part — HomUG-ObGy-I in the NCH curriculum — introduces the study of women’s reproductive health, pregnancy, childbirth and the care of the newborn, and it does so within an explicitly homoeopathic frame: the Hahnemannian classification of disease, the homoeopathic literature, case taking, repertorisation, and the scope and limitations of homoeopathy.

The CBDC course content is arranged in two units.

**Unit 1: Gynaecology and Homoeopathic Therapeutics.** The unit opens by introducing gynaecology alongside the definition of the Hahnemannian classification of disease, and it names the importance of reviewing the homoeopathic literature, therapeutics and the repertory’s source books. From the very first topic, then, the student is asked to hold two frames at once: the clinical science of gynaecology and the homoeopathic way of classifying and reading disease.

The unit then reviews the applied anatomy of the female reproductive system, with its development and developmental anomalies, and its applied physiology — puberty, menstruation, menopause, and the disorders associated with them. These reviews build directly on the first year: the anatomy of the pelvis and reproductive organs from Anatomy, and the menstrual cycle, ovulation and menopause from Physiology.

Gynaecological case taking follows, with physical examination, investigation, and the approach to clinical and differential diagnosis. This is where the second-year Organon and Repertory courses, both of which teach case taking, meet a clinical specialty for the first time.

Three further topics bring the homoeopathic frame to the fore. One studies epidemiology and predisposition, including fundamental miasm and personality type. One studies uterine displacements with their exciting and maintaining causes — the Organon’s own language of causation, which the second-year Organon course studies in its chapter on predisposing, fundamental, exciting and maintaining causes. One studies sex and intersexuality through a homoeopathic outlook on predisposition, miasm and personality. The unit closes with general and homoeopathic management — repertorisation, therapeutics, posology, and the formulation of prognostic criteria and prognosis.

**Unit 2: Obstetrics, Newborn Care and Homoeopathic Therapeutics.** The second unit introduces obstetrics and newborn care in relation to homoeopathic philosophy, therapeutics and repertorisation, and then follows the course of a pregnancy:

– the fundamentals of reproduction and the development of intra-uterine pregnancy;
– the diagnosis of pregnancy, with its investigations and examinations, and the physiological changes of normal pregnancy;
– antenatal care — its aims, visits, advice, procedures and investigations, the identification of high-risk cases, and the scope and limitation of management in homoeopathy;
– common conditions of pregnancy;
– normal labour — its onset, anatomy, physiology, mechanism, stages and clinical course;
– the postnatal period and the puerperium, again with scope and limitation named;
– and the care of the newborn from the homoeopathic point of view.

The unit ends, like the first, with general and homoeopathic management and prognosis, and with the important investigations for diagnosis in obstetrics.

**Reading the syllabus well.** Two phrases recur through this syllabus and deserve attention: “scope” and “limitation”. The curriculum does not ask a student to believe that homoeopathy answers every question in obstetrics; it asks them to know which questions it can address and which it cannot, and it names the identification of high-risk cases as part of antenatal care. That is a clinician’s discipline, and it is the frame in which this platform writes. Pieces in this room describe the syllabus and its concepts; they give no treatment advice, and they will not pair any condition with any medicine.

**Connections across the year.** Forensic Medicine marks two of its chapters — on pregnancy and delivery, and on abortion and infanticide — for integration with this subject. Community Medicine’s chapter on reproductive, maternal, newborn, child and adolescent health covers the same ground at the scale of the population. The Materia Medica course of the year asks students to integrate gynaecology and obstetrics into their reading of the materia medica.

As this room fills, a student will find pieces written to this syllabus: orientations to both units, review notes that link the applied anatomy and physiology back to the first year, explainers on gynaecological and obstetric case taking as the Organon frames it, and study notes on how the Hahnemannian classification of disease and the concept of miasm are used in the syllabus. Everything here carries the second-year tag and the Gynaecology and Obstetrics category; the third-year room continues the subject.