Pathology and Microbiology in the Second Year — the study of disease itself

The first year of BHMS studied the body as it is when it is well. Pathology and Microbiology — coded HomUG-Path M in the NCH curriculum — is the Second Professional subject that studies what happens when it is not: how tissues and organs change in disease, and the microorganisms and parasites that live with, and sometimes against, the human body. It is a para-clinical subject, standing between the pre-clinical sciences of the first year and the clinical subjects that begin alongside it.

The CBDC course content lists nineteen chapters by name. The source document gives chapter names without sub-topics, so this orientation keeps to what those names state and how the curriculum orders them. The order is instructive in itself.

**Pathology.** The subject opens with an introduction to pathology and then general pathology — the principles that hold across the body. Systemic pathology, the study of disease organ system by organ system, comes later in the chapter list, after the foundations of microbiology have been laid. The arrangement reflects a sensible sequence: general principles first, then microorganisms, then the organ systems in which both are seen.

**Microbiology, from method to organism.** The microbiology chapters begin with an introduction to the discipline and then its working methods: sterilisation and disinfection, and culture media and methods. They continue with infection and disease, and the human microbiome, the community of microorganisms that live in and on the body.

The organisms are then studied in groups. For bacteria: gram-positive bacteria, gram-negative bacteria, acid-fast bacteria and spirochaetes. For viruses: an introduction to virology, followed by DNA and RNA viruses. For parasites: an introduction to parasitology, the protozoans, and the helminths. And for fungi, a chapter on mycology.

**Diagnosis.** The last chapter is diagnostic procedures in microbiology — the laboratory methods by which organisms are identified. It closes the loop that sterilisation and culture opened at the start.

**Why a homoeopathic student studies pathology.** The question deserves a direct answer, because students sometimes ask it. A homoeopathic physician individualises, and attends to the whole person rather than to a disease name alone. But the physician must still understand what disease is, how it progresses, and what the findings of an examination or a laboratory mean. The Organon course of this same year studies causation, the evolution of disease, and the progress of disease — and a student who knows pathology reads those chapters with more understanding, not less.

The curriculum states these links explicitly. The second-year Materia Medica course asks the student to integrate the knowledge of pathology into a better understanding of the materia medica. The second-year Repertory course studies the representation of different pathologies and pathogenesis in Boericke’s and Kent’s repertories. The Practice of Medicine course of the same year is organised around the clinico-pathological evaluation of common signs and symptoms. In each case, pathology supplies the language.

Microbiology has its own connections: to Community Medicine, whose syllabus covers communicable diseases and hospital-acquired infections; to Surgery, with its chapters on surgical and special infections; and to the first-year Pharmacy course, which studies nosodes among the sources of homoeopathic drugs.

**The student’s approach.** This is a subject of many names and classifications, and it rewards structure. Learning the organising scheme — general before systemic, method before organism, group before species — makes the detail easier to place.

As this room fills, a student will find pieces written to this syllabus: orientations to general and systemic pathology, study notes that lay out the classification of organisms the chapter list follows, explainers on sterilisation, culture and diagnostic method, and pieces that show where pathology meets the Organon’s account of disease and the repertory’s representation of pathology. Everything here carries the second-year tag and the Pathology and Microbiology category. The room fills in the order of the syllabus.