ClinicalDialoguesPart1.Womancomplainedoftightnessinabdomenassociatedwithbelching(噯氣)windwhichdidnotrelievefeeling.Symptomsusuallybeganbetween5and6p.m.lastingseveralhours.Relievedbywhitemixture.

(D=Doctor,P=Patient)0102Doesthepaincomeoninthenight?

[comeon:tostart

Ifacold,headache,orsomeothermedicalconditioniscomingon,itisjuststarting.

g.Ifeltacoldcomingon.我覺得開始感冒了。]

P:Notoften.D:Whenitcomeson,doyougetup?P:Yes,Igetupandwalkaroundanditrelieves.壹貳PainIhaveaheadache.01Ihaveasplittingheadache.（我頭痛得像要裂開了。）02Ihaveastomach-ache.03Ifeeladullpaininthestomach.04Iseemtohavepainallover.（我似乎渾身都痛。）05I’machingallover.（我渾身都痛。）06Itstartedtwodaysago.It’sadullsortofpain,andIdon’tknowwhat’scausingit.Itallbeganyesterday.It’snotasharppain;justsortofadullache.Ithurtsterrible.（痛得很厲害。）Itcameonlastnight.01It’sbeenhangingaboutfornearlyaweek.（這已經(jīng)持續(xù)了將近一個星期了。）02Itkeepshangingon.（這老是不好。）03Itsortofhungon.（這似乎不見好。）04Or:Justoffandon.（就是時斷時續(xù)。）05I’vegotapaininmyback.（背疼）01Myeyeshavebeensore.（眼睛發(fā)痛）02Myleftfoothurts.03Mytoothisachingupagain.04IfeelshiveryandI’vegotasorethroat.（我覺得怕冷發(fā)抖，而且喉嚨疼痛。）05Thepain’sbeenkeepingmeawake.D:Doesanythingbutthewhitemixturehelpit?010102P:I’vebeenonastrictdietforsixmonths.Inevertouchmilk.02onadiet:Ifyouareonadiet,youareeatingspecialkindsoffoodbecauseyouwanttoloseweight.（為減肥）節(jié)食touch:Ifyoudonottouchaparticularkindoffoodordrink,younevereatitordrinkit.吃；喝e.g.Drink?No,shenevertouchesthestuff.喝酒？不，他從不喝這種東西。D:Doesanypositionhelpyou?D:Haveyoubeensick?（你嘔吐過嗎？）

(=Anyvomiting?)P:No,Itcomesonaftertea,aboutfive.Ihavemymainmealmidday.P:OnlyatthebeginningIwasverysickthen.Asickpersonhasanillnessorsomeotherproblemwiththeirhealth.

Tobesickmeanstobringupfoodthroughyourmouthfromyourstomach.e.g.IthinkI’mgoingtobesick.0102Notethat“Georgeisbeingsick”means“Georgeisbringingupfoodfromhisstomach”;“Georgeissick”means“Georgeisill”.However,“Georgewassick”canmeaneither“Georgebroughtupfoodfromhisstomach”or“Georgewasill”.Vomithasthesamemeaningas“besick”.Vomitisafairlyformalword.

e.g.Shewasstrickenwith(被...折磨)painandbegantovomit.

Throwup:Inconversation,somepeoplesay

throwupinsteadof“besick”.

e.g.IthinkI’mgoingtothrowup.

I’vebeenthrowingup.我一直嘔吐。D:Doyoufeelsick?（惡心嗎？）010203(=Haveyougotanyfeelingofnausea?)(=Areyoufeelingnausea?)P:Yes,IfeelsickbutIcan’tbesick.（我經(jīng)常惡心，但不再嘔吐。）Feelsick:Tofeelsickmeanstofeelthatyouwanttobesick.

e.g.Flyingalwaysmakesmefeelsick.Note:

ILLandsickarebothusedtosaythatthatsomeonehasadiseaseorsomeotherproblemwiththeirhealth.

e.g.Davisisill.

Youruncleisverysick.

Asickchild…MostBritishspeakersdonotuseillinfrontofanoununlesstheyarealsousinganadverb(副詞).Forexample,theydonottalkabout“anillwoman”,buttheymighttalkabout“aseriouslyillwoman”.…aterminallyillpatient.AmericanandScottishspeakerssometimesuseillinfrontofanounwithoutusinganadverb.Wehadtogetmedicalhelpforourillsisters.0102D:Doesthepaingothroughtotheback?

P:No,butitgoesundermyarmpits.（腋下）

D:What’syourweightbeendoing?（你的體重最近怎樣？）

(=Haveyoulostweightrecently?)

P:I’velostoneandhalfstonebutI’vebeenonafat-freedietforsixmonths.

(or:Myweightfellfrom65kg.to50kg.)Stone:aunitofweightinGreatBritain,14pounds(6.4kilograms)英石[英國重量單位，等于14磅(6.4公斤）]D:What’syourappetitelike?（你的胃口怎樣？）

(=Howaboutyourappetite?)

(=Doyouhaveanyappetite?)What’s(your)/(the)…?/Whatseemstobethe…?What’syourappetitelike?What’syourcomplaint?(你有什么不舒服？)

=What’syourtrouble?

=What’sthetrouble?

=What’sbotheringyou?

=Whatseemstobebotheringyou?=Whatseemstobetheproblem?=What’swrongwithyou?=What’sthematterwithyou?=Whatseemstobethetrouble?=Whathurtsyou?=Whatdoyoucomplainof?=Whatseemstobethematter?P:Poorasever.

(=I’vegotabadappetite.)

D:Whataboutyourbowels?（大便如何？）

(=Areyourbowelsactingproperly?)

(=Areyourbowelsregular?)

P:Igotwiceaday,inthemorning.D:Isthisalife-longhabit?P:Yes.D:Whatdothemotionslooklike?Well-formed,firm?（大便什么形狀？成形，堅實嗎？）P:Yes.D:Whataboutthecolor?Hasitchanged?P:No.D:Aretheydark?P:Yes.D:Anysignofblood?P:No.D:Dotheyfloatonthewaterwhenyouflushthelavatory?（你沖洗廁所時，它漂浮在水面上嗎？）P:No.01020304D:Haveyounoticedanunpleasantsmell?D:Haveyounoticedanydifferenceinyourwater?（你排尿有無異常？）05D:Doyouhavetogetupinthenight?（你夜間起來上廁所嗎？）P:No.P:No.P:Once.06D:Yourwaterhasn’tbeendarker?01D:Doyousmoke?03D:Doyoudrink?05P:No.02P:10aday.04P:Notmuch.06D:Haveyouanyothertrouble?P:No,myangina’sbeenverygood.（我的心絞痛已經(jīng)好了。）I’venothadmuchtroublewiththatfortwoyears.（這兩年沒大犯過。）

-Or:Ifeelabsolutelyrotten.（我覺得身體很不舒服、非常虛弱。）

[Ifyoufeelorlookrotten,youfeelorlookill]Ifeelabitoffcolor.（我覺得有點不舒服。）

[Here,colormeansreddish-pinkcolorinone’sfacethatshowsthatone’shealthisgood.面色；血色]

Ifeelsoill.

Ifeelratherunwell.

Ifeelverybad.Ireallyfeelterrible.

IthinkI’mdying.（我難受極了。）

I’mfeelingratheroutofsortsthesedays.（這些天我覺得身體很不舒服。）

[Ifyoufeeloutofsorts,youfeelslightlyunwell,discontented,orannoyed.身體不適；心情不佳；煩惱]I’mundertheweather.（我不舒服。）

[Ifyousaythatyouareundertheweather,youmeanthatyoufeelslightlyill.]

Mywholebodyfeelsweak.

Ijustfeelallpoopedout.（我只覺得精疲力竭。）

[bepoopedout:tobeverytired;usedmainlyininformalAmericanEnglish.]D:You’vealsohadtroublewithyourleg?P:Yes,theythoughtitwasthrombosis(血栓).D:Whendidyoufirststartwithyourtummytrouble?（第一次胃病是什么時候發(fā)作的？）Tummy:thehumanstomachorbelly肚子，胃P:About14yearsago.D:Thesame,butmorebothersomenow?（現(xiàn)在是否更厲害?）

P:Yes,it’stighter.

（病情更重了。）

Warning:

1)Youdonotsaythatsomeonebecomes“iller”or“moreill”.Yousaythattheybecomeworse.

2)Youdonotuseillorsicktosaythatsomeonehasreceivedaninjury.Yousaythattheyareinjuredorhurt.D:Haveyoueverbeenjaundiced?（得過黃疸嗎？）P:No.D:Isyourtummyswollenwhenyoufeellikethis?（犯病時肚脹嗎？）P:ItfeelsasthoughI’mgoingtoburst.（我覺得肚子快要爆炸了。）D:Well,I’dliketohavealookatyou.（檢查一下）Willyougetundressedandlieonthecouchplease?（請脫去衣服，躺在檢查床上。）Or:Liedownonthecouchthere.Letmejustsee.Liedownonthecouchthere.Letmeexamineyourbelly.Wouldyoumindtakingoffallyourclothesexceptyourpants(formen)/exceptyourpantsandbra奶罩(forwomen)?Lieonthecouchandcoveryourselfwiththeblanket.1Well,let’ssee.2Nowslipoffyourcoatandshirt,please.3Striptoyourwaist,please.把上身衣服脫掉4ARollyoursleeveup.BSlipyourshoesoffandhopuponthebed.CSlipoffyourshoesandsocks.DLetmecheckyourlungsandheart.ELetmelistentoyourlungsandheart.STEP5STEP4STEP3STEP2STEP1Letmeexamineyourstomach.Letmesoundyourlungs.(叩診)Unbuttonyourshirtandletmelistentoyourlungs.Openyourmouthandsay“Ah”.Openyourmouthplease,andshowmeyourtongue.01Putthisthermometer(體溫計)underyourtongue.03Well,I’dbettertakeyourbloodpressure.04MayItakeyourbloodpressure?02I’llhaveyourtemperaturetaken.05Letmetakeyourbloodpressure.ClinicalExaminationDuringtheexaminationthedoctoraskedthefollowingquestions:P:No.D:Doyousufferfromheartburn?P:Yes.Alovelycolorinthewinter!（冬天簡直紅得可愛！）D:Areyourhandsalwayscoldandred?P:No.D:Haveyouhadanychildren?01040203D:Justholdyourbreathforamoment.Breathethroughyourmouth.Showmewhereyougetthispain.Yourage?P:72.D:Yourperiodsfinishedwhen?（你什么時候停經(jīng)的。）P:WhenIwasabout52or3.D:Anytendernesshere?P:It’sabitsorebutnotalot.D:Doesitcatchyouatallwhenyoubreathe?（你每次呼吸都覺得痛嗎？）P:No.01040203D:Haveyouanypainsinyourlegs?

(=Doyouhaveanypainsinyourlegs?)P:Igetcramp（抽筋）abitwhenI’minbed.D:Moreinonelegthantheother?P:Igetitinmyrightleg;that’smyvaricose（靜脈曲張）leg.D:Apartfromthis,you’vehadnootherseriousillnessinthelast14years?

P:No.

D:I’mgoingtotakeadropofyourbloodandI’dlikeyoutohaveastomachX-ray.You’llhavetocomespecially,don’teatanythingbeforeanddrinkawhitepastewhichoutlinesyourstomachandwe’lltakesomepictures.Or:01Ithinkwe’dbettergiveyouafewtests.02Abloodtestisnecessary.03Takeyourbloodcountfirst,please.04You’retohaveabloodtest.05STEP4STEP3STEP2STEP1I’mgoingtotakeathroatculturesowe’llknowforsure.Youmusthaveanelectrocardiographexamination.Well,let’stakeanX-rayofyourchest.GoandhaveyourchestX-rayed.BOWELS大便

Medicalwords:faeces,stools,todefaecate

Colloquialwords:motion,tohavethebowelsopenedUsefulquestions

?Howoftendoyouhaveyourbowelsopened?

?

Isthisalife-longhabit?

?

Whatdothemotionslooklike?

?

Aretheyquitewellformed?

?

Whataboutthecolor?

Hasitchanged??

Aretheydarkerincolor？

?

Haveyoueverseenanybloodinyourmotions?

?

Haveyounoticedanunpleasantsmell?

?

Doyoueverhavediarrhea(腹瀉)orconstipation(便秘)

?

?

Doyouhavetogoinahurry?（上廁所）

?

Canyouholdyourmotions?（控制排便）?Doyouhavetostrain(用力)topassyourmotions?(tenesmus)（里急后重,下墜）?Doyoutakelaxatives(輕瀉劑)??Dothemotionsfloatonthewaterafterflushingthelavatory??Doyoueverhaveanypainonpassingyourmotions?STEP1STEP2STEP3STEP4?Doyougetpainbefore,duringorafterpassingyourmotions??Doyousufferfromwind??Haveyounoticedanyspecialfoodupsetsyourbowels??Haveyoulostanyweight?Descriptivewords1Color:black,brown,clay-like,colorless-likerice-water(cholera霍亂),darkbrown,green,grey,pale,pea-soup-like,putty-like(油灰樣),porridge-like)(麥片粥樣)(steatorrhoea脂肪痢),jelly-like,tarry(柏油樣),white,yellow,etc.2Formandconsistency(稠度):bloody,bulky,dry,fatty,floating,friable,frequent,frothy(泡沫樣的),greasy(油脂過多的),hard,harddryballs,loose,purulent(膿性的),slimy(粘液的),soft,watery,well-formed,worms,etc.01Amount:copious,scanty02Odor:offensive(verybad)UsefulExpressions

Greeting

?“Goodmorning,Mrs.Rayner,comeandsitdown.”

Askingpatientstodescribetheirsymptoms

?“Wellnow,howcanIhelpyou?”

?“Well,Mrs.Rayner,what’sthetrouble?”

?“Yourdoctorsaysyou’vebeenhavingtroublewithyourback.Tellmeaboutit.”Collectingcases

Mentionedabove.

Directingpatientshowtoundress

?“Wouldyoumindtakingoffallyourclothesexceptyourpants(formen)/exceptyourpantsandbra(forwomen)?Lieonthecouchandcoveryourselfwiththeblanket.”

?“Slipoffyourshoesandsocks.”

?“Rollyoursleeveup.”Directingpatientshowtoassumeappropriatepositions

?“Pleaselieonyourtummy.”

?“Pleaseturnoverandlieonyourback.”

?“Rolloverontoyourleftside.”

?“Bendyourknees.”01?“Walkacrosstheroom.”?“Situp.”?“Leanforward.”?“Getoffthecouchandstandup.”020304painful:Yousaythatsomethingispainfulwhenitmakesyoufeelpain.

e.g.alongandpainfulillnessIfapartofyourbodyispainful,ithurts.

e.g.MybackissopainfulthatIcannotstandupright.Whensomeonefeelspain,youdonotsaythattheyare“painful”.Yousaythattheyareinpain.01e.g.Hewasinpainandcouldnotmoveintoacomfortableposition.02Part2.D:Iseeyouhavehadseveralattacksofinfluenza(流行性感冒).Anythingelse?01P:I’vehaddizziness(頭暈目眩)andI’vebeensick.02Ifyoufeeldizzy,youfeelthatyouarelosingyourbalanceandareabouttofall.03Tobesickmeanstobringupfoodthroughyourmouthfromyourstomach.04D:Howoftenaretheattacks?P:Nearlyeveryday.P:Twomonthsago.D:Whendidthisstart?D:Howlongdotheylast?

P:Somelastallday,some

acoupleof

hours.

“Acoupleofthingsorquantities”meansapproximatelytwothingsorquantities.Youusethisinformalexpressionwhenyouarenotsureoftheexactnumberofthingsorquantitiesyouarereferringtoandthenumberisnotimportant.D:Doesanythingbringontheseattacks?

bringon:tocausetooccur引起（疾病、痛苦、發(fā)作等）Youcanusethestructure“Somethingbringsonanillness,pain,orattack”.P:No.D:Willyoudescribeoneoftheseattacks?P:Itstartswithaheadache—athrobbing(跳動)headache.Myeyesstartrunning.Ican’ttouchthem,theyaresosore(疼痛的).Andthenthewholehousegoesround.Thenitgoesdark.D:Doyouseeflashinglights(閃光)?P:No.D:Whenyousayyougodizzy,whatdoyoumean?P:IfeelI’llfalloverandtheroomspins(旋轉)round.IfIgotobed,thebedgoesround.fallover:Ifyoufalloverfromanuprightorstandingposition,youbecomeunbalancedandfalltotheground,lyinglengthways(縱向地)orinaheap.跌倒；摔倒D:Whenyoumove,doyoustagger?

stagger:tomoveorstandunsteadily,asifyouabouttofall蹣跚；搖晃

P:I’mtooscaredtomove.（嚇得一點都不敢動）

Ifyouarescared,youareveryfrightenedofsomeoneorsomething,andthereforeunabletobehavecalmly.吃驚的；嚇壞了的P:No.05D:Doyoubringanythingup?（有沒有嘔吐vomit/痰sputum？）03D:Haveyounoticedanythingelse?01Whenyoubringupfood,youvomit;aninformaluse.04P:Icoughalot.021D:Isyourhearingaffected?Doyouhavebuzzing(嗡嗡聲)orringingnoises?2P:Yes.3D:Inbothears?4P:Yes.D:Whenyougotobed,doyousleep?

P:Ijustlieanditgoesoffwithinafewhours.

Ifyougooff,youfallasleep;aninformaluse.入睡

e.g.Hewentoffassoonashisheadtouchedthepillow.D:Haveyoueverwokenuplikethis?01wakeup:Whenyouwakeuporsomethingwakesyouup,youbecomeconsciousagainafterbeingasleep.醒來；喚醒02Youcanuse“l(fā)ikethis”or“l(fā)ikethat”whenyouaredrawingattentiontosomethingthatyouaredoingorthatsomeoneelseisdoing.像這樣（引起對正做之事的注意）01e.g.Sorrytobreakinonyoulikethis(原諒我這樣打擾您),Dr.Mark.0201P:No.Itisalwaysintheday.02D:Doesmovementoftheheadcauseit?03P:No.04D:Ifyousuddenlygetupoutofachairdoesitstart?05P:No.P:Ihadmygallbladder(膽囊)removed.3124D:Howlonghaveyoubeendiabetic(糖尿病)?P:Fouryears.D:Anyotherseriousillness?“havesth.done”pattern

GoandhaveyourchestX-rayed.

Youmusthaveyourtoothextracted.

Youmusthaveyourappendix(闌尾)removed.

You’llhavetohaveyourdecayedtoothpulledout.D:Anythingelse?P:IhadVD[性病(venerealdisease)]nineyearsago.Iwasinhospitalforthreeweeksandhadacourseofinjections(注射).ClinicalExaminationTakeadeepbreathinandholdyourbreath.Closeyoureyesgently.Nottootight.Lookuptotheceiling(天花板).Holdyourarmsout.Areyourbowels(大便)allright?1Yes.2D:Notroublewithyourwater(排尿)?01P:No.02D:Yourperiods(絕經(jīng))finishedsomeyearsago?03P:Yes.Fouryearsago.04D:Well,theredoesn’tseemanythingseriouslywrongwithyou.I’dlikeyoutohavesomeX-raysthroughandabloodtest.DiagnosingandtreatingBythelookofit,itshouldbearash.從表面看，這應該是皮疹。01Bythesoundofit,it’sbronchitis(支氣管炎).02Itlookslikemeasles.看上去像麻疹。03Itlooksasifit’sSLE.看起來這似乎是紅斑狼瘡。04Itsoundsasifyou’vecaughtcold.聽上去你似乎得了感冒。Ishouldsayyou’vecaughtcold.感冒Ishouldthinkyou’vegottheflu.流行性感冒Itsoundslikebronchitis.聽起來像支氣管炎。Youprobablyhavecontractedtheflu.你大概得了流行性感冒。01Youseemtohavepickedupsomekindofinfection.你似乎已受了某種感染。02ItcouldbeacaseofTB.可能是肺結核病。03It’sinflammationoftheskin.04You’resufferingaheartdisease,I’mafraid.1You’rerunningatemperature.你在發(fā)燒。2You’vegotadropoffever.你稍許有點熱度。3Idon’tthinkit’sanythingserious.我看這并不嚴重。4It’snotsoseriousasitseems.這并不像表面顯示的那么嚴重。5There’snothingtobealarmedabout.沒什么可大驚小怪的。Yourcaseisnotveryserious.Nothingserious.沒什么大問題。You’vegottheflu,butnotveryserious.It’snothingserious,butyou’dbetterstayinbed.It’snothingbutalittleinfectioninthefingertip.這只不過是指尖有點感染。You’llbeallrightsoon.你不久就會康復的。

=You’llgetoveritsoon.Ifyourrecoverygoesonlikethis,youcanleaveinthreedays.如果你的康復情況像這樣繼續(xù)下去，過三天你就可以出院了。Ithinkyouneedashottodeadenthepa