Practice of Medicine in the Third Year — the body’s systems, one by one

The second-year course in Practice of Medicine taught a student to begin with a symptom and reason towards its cause. The third-year course — HomUG-PM-II in the NCH curriculum — reverses the direction. It takes the body’s systems one at a time and studies the diseases of each: how they arise, how they present, how they are recognised and distinguished. The two approaches are complementary, and a clinician needs both. The fourth year continues the subject.

The CBDC course content has six chapters, each devoted to a system or a group of related disorders. Each chapter, in the curriculum’s own arrangement, closes with an entry on the homoeopathic therapeutics of that system — a topic of study for the classroom and the teacher, and one that this platform’s pieces will not turn into advice.

**Pulmonary disorders.** The chapter begins with the approach to a patient with disease of the respiratory system, and then works through the upper respiratory tract, the airways, the lung tissue and the pleura, including infections, obstructive and interstitial disease, occupational and environmental lung disorders, vascular disease of the lung, neoplasia and hyperventilation syndromes. It builds on the first-year anatomy of the thorax and the physiology of respiration, and on the systemic pathology of the second year.

**Urogenital tract diseases.** Focused on the kidney, this chapter opens with symptomatology, the clinical syndromes and renal function tests, and then covers infections of the urinary tract, diseases of the glomerulus and the tubules and interstitium, acute and chronic renal failure, renal vascular disease, stones and obstruction, cystic disease and tumours of the genito-urinary tract. It rests on first-year renal physiology, where urine formation and renal function tests were first studied.

**Disorders of water and electrolyte balance.** A short chapter with a clear logic: an approach to electrolyte disorders, then the high and low states of sodium, potassium and phosphate, and the metabolic and respiratory forms of acidosis and alkalosis. The second-year course included fluid and electrolyte imbalance among its common presentations; here the disorders are studied in their own right.

**Diseases of the digestive system and peritoneum.** The chapter begins with the applied anatomy and physiology of the gut and then moves through it from mouth to anus: disorders of the mouth and salivary glands, the oesophagus, the stomach, the small and large bowel with their malabsorptive, functional and inflammatory conditions, and anorectal disorders, together with infection and neoplasia of the bowel.

**Diseases of the liver, gall bladder and pancreas.** After a clinical approach to hepatobiliary and pancreatic disease, the chapter studies the forms of hepatitis, liver disease related to alcohol, cirrhosis with its complications, abscess and cysts, the diseases of the gall bladder, pancreatitis and malignancy of the liver.

**Endocrine diseases and metabolic disorders.** The last chapter begins with an approach to endocrine disorders and then takes the glands in turn: thyroid, parathyroid with calcium balance, adrenal, and pituitary, with disorders of growth and the two forms of diabetes that share a name. First-year endocrinology, with its attention to the PNEI axis, is the foundation.

**Reading the chapter structure.** Most chapters begin with an approach — to the patient, to the system, to the class of disorder — or with the applied anatomy and physiology of the system, before they list diseases. That ordering teaches a habit: the clinician starts from the person in front of them and from the system as a whole, not from a list of names. It is a habit a homoeopathic student will recognise from the Organon, which the third-year course reads on the management of acute, chronic and other kinds of disease and on scope and limitation.

**Where the subject connects.** The third-year Repertory course asks students to identify chapters and locate rubrics for conditions related to Practice of Medicine. The Materia Medica course of the year asks them to integrate the knowledge of Practice of Medicine into their understanding of the materia medica. And the Pharmacology course, studied in the same year, surveys the modern drugs used in the same systems — a student who is learning the disorders of a system and the pharmacology of that system in the same months will find each subject easier for the other.

A note on how this room is written. It is study material for BHMS students. Pieces here explain disease, diagnosis and the syllabus’s reasoning. They do not advise anyone about their own health, and they never pair a condition with a medicine.

As this room fills, a student will find pieces written to this syllabus: system-by-system orientations, study notes on the clinical approach that opens each chapter, review pieces that link each system back to its first-year anatomy and physiology and its second-year pathology, and explainers on diagnosis and differential diagnosis as the syllabus frames them. Everything here carries the third-year tag and the Practice of Medicine category, so it also stands on the Practice of Medicine topic in Homoeopathy Knowledge.