1、A Nation of Hypochondriacs,Norman Cousins,Medicine and Health,Definition and the importance of health,Health is defined in the WHO constitution of 1948 as: A state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity. Within the context of health pro

2、motion, health has been considered less as an abstract state and more as a means to an end which can be expressed in functional terms as a resource which permits people to lead an individually, socially and economically productive life. Health is a resource for everyday life, not the object of livin

3、g. It is a positive concept emphasizing social and personal resources as well as physical capabilities.,What is health?,Importance of health,The biggest wealth in life is -health. Without health, everything is nothing.,Present situation,Recently the number of people who are in subhealth is increasin

4、g remarkably. At the beginning of 2009, Chinese Center for Disease Control announced that the data of each kind of mental illness patient is above 100,000,000 people. About 250,000 people suicide every year in china.(Zhongxin net),Subhealth :,Mental illness :,The rate of suicide :,The four major fac

5、tors affecting health,1. Acts and lifestyle factors(行為和生活方式） Behaviour and lifestyles that are due to their own bad behaviour and lifestyles, directly or indirectly the adverse effects to health. such as diabetes, hypertension, coronary heart disease, colon, breast, prostate cancer, obesity, sexuall

6、y transmitted diseases and AIDS, mental diseases, such as suicide and behaviour and lifestyles. 行為和生活方式因素是指因自身不良行為和生活方式，直接或間接給健康帶來的不利影響。如糖尿病、高血壓、冠心病、結(jié)腸癌、前列腺癌、乳腺癌、肥胖癥、性傳播疾病和艾滋病、精神性疾病、自殺等均與行為和生活方式有關(guān)。,Affecting the health and health factors affecting almost all of the Role and conduct. such as smoking

7、and lung cancer, Chronic Obstructive Lung Disease, ischaemic heart disease and other cardiovascular diseases are closely linked. alcoholism, drug abuse, extramarital sexual misconduct, and serious harm to human health. 行為是影響健康的重要因素，幾乎所有影響健康因素的作用都與行為有關(guān)。例如吸煙與肺癌、慢性阻塞性肺病、缺血性心臟病及其他心血管疾病密切相關(guān)。酗酒、吸毒、婚外性行為等不

8、良行為也嚴(yán)重危害人類健康。,behavior factor,life style,The way of life and the poor by the chronic non-communicable diseases, AIDS and sexually transmitted diseases in the rapidly increasing. In recent years my malignant tumours, cerebrovascular and cardiovascular diseases accounted for 61% of total deaths. Accor

9、ding to the United States, as long as the behavioural risk factors: unreasonable diet, lack of physical exercise, smoking, alcohol and drug abuse, can be reduced by 40% to 70% of the dead, 1/3 of the acute disability, 2/3 of the chronic disabilities. 由于生活方式和不良行為導(dǎo)致了慢性非傳染性疾病及性病、艾滋病的迅速增加。近年來我國(guó)惡性腫瘤、腦血管病

10、和心血管病已占總死亡原因的61。 據(jù)美國(guó)調(diào)查，只要有效地控制行為危險(xiǎn)因素：不合理飲食、缺乏體育鍛煉、吸煙、酗酒和濫用藥物等，就能減少4070的早死，13的急性殘疾，23的慢性殘疾。,Environmental factors,Natural Environment To maintain the natural environment and human harmony, and protect, promote the health of the 10 importance. If they destroy human harmony with nature, human society w

11、ill suffer a retaliatory nature. 自然環(huán)境 保持自然環(huán)境與人類的和諧，對(duì)維護(hù)、促進(jìn)健康有著十分重要的意義。若破壞了人與自然的和諧，人類社會(huì)就會(huì)遭到大自然的報(bào)復(fù)。,Environmental factors,(2)Social Environment Social Environment including legal, social, economic, cultural, education, population, ethnic, professional, social and health of the relevant policies, laws a

12、nd regulations。 社會(huì)環(huán)境 包括社會(huì)制度、法律、經(jīng)濟(jì)、文化、教育、人口、民族、職業(yè)等，社會(huì)制度確定了與健康相關(guān)的政策、法律、法規(guī)等。,Biological factors,Biological factors inherited Genetic 。According to an investigation, the national birth defects Total incidence of 13.7% , with severe mental retardation, 2 million people each year. genetic and hypertension

13、, diabetes, cancer and other diseases . 生物學(xué)因素 遺傳 據(jù)調(diào)查，目前全國(guó)出生嬰兒缺陷總發(fā)生率為137，其中嚴(yán)重智力低下者每年有200萬人。遺傳還與高血壓、糖尿病、腫瘤等疾病的發(fā)生有關(guān)。,Preparation,1. Have you heard of a Chinese idiom “suspecting ones neighbor of stealing an axe”? What is the story? And what kind of lesson can we learn from it? 2. If you are not feeling

14、 well, will you go to see a doctor immediately? Why or why not?,疑鄰盜斧,人有亡鈇者，意者鄰之子，視其行步，竊鈇也；顏色，竊鈇也；言語(yǔ)，竊鈇 也；動(dòng)作態(tài)度，無為而不竊鈇也。俄而抇其谷而得其鈇，他日復(fù)見其鄰人之子，動(dòng)作態(tài)度，無似竊鈇者。 這則寓言說明，主觀成見，是認(rèn)識(shí)客觀真理的障礙。當(dāng)人以成見去觀察世界時(shí)，必然歪曲客觀事物的原貌。,疑鄰盜斧譯文,從前有個(gè)（鄉(xiāng)下）人，丟了一把斧子。他懷疑是鄰居家的兒子偷去了，便觀察那人，那人走路的樣子，像是偷斧子的；看那人的臉色表情，也像是偷斧子的；聽他的言談話語(yǔ)，更像是偷斧子的，那人的一言一行，一舉

15、一動(dòng)，無一不像偷斧子的。不久后，他（丟斧子的人）在上山的時(shí)候發(fā)現(xiàn)了他的斧子，第二天又見到鄰居家的兒子，就覺得他言行舉止沒有一處像是偷斧子的人了。,The main impression growing out of twelve years on the faculty of a medical school is that the No.1 health problem in the U.S. today, even more than AIDS or cancer, is that we dont know how to think about health and illness. Ou

16、r reactions are formed on the terror level. We fear the worst, expect the worst, thus invite the worst. The result is that we are becoming a nation of weaklings and hypochondriacs, a selfmedicating society incapable of distinguishing between casual, everyday symptoms and those that require professio

17、nal attention.,Somewhere in our early education we become addicted to the notion that pain means sickness. We fail to learn that pain is the bodys way of informing the mind that we are doing something wrong, not necessarily that something is wrong. We dont understand that pain may be telling us that

18、 we are eating too much or the wrong things; or that we are smoking too much or drinking too much; or that there is too much emotional congestion(擁擠) in our lives; or that we are being worn down by having to cope daily with overcrowded streets and highways, the pounding noise of garbage grinders（垃圾粉

19、粹機(jī)）, or the cosmic distance between the entrance to the airport and the departure gate. We get the message of pain all wrong. Instead of addressing ourselves to the cause, we become pushovers for pills, driving the pain underground and inviting it to return with increased authority（power）.,Early in

20、life, too, we become seized with the bizarre(奇異) idea that we are constantly assaulted by invisible monsters called germs, and that we have to be on constant alert to protect ourselves against their fury. Equal emphasis, however, is not given to the presiding(首席的) fact that our bodies are superbly e

21、quipped to deal with the little demons, and that the best way of forestalling(預(yù)防；囤積 ) an attack is to maintain a sensible life-style.,The most significant single statement about health to appear in the medical journals during the past decade is by Dr. Franz Ingelfinger, the late and former editor of

22、 the New England Journal of Medicine. Ingelfinger noted that almost all illnesses are self-limiting（自我限制）. That is, the human body is capable of handling them without outside intervention. The thrust of the article was that we need not feel we are helpless if disease tries to tear away at（疾馳，撕裂） our

23、 bodies, and that we can have greater confidence in the reality of a healing system that is beautifully designed to meet most of its problems. And even when outside help is required, our own resources have something of value to offer in a combined strategy of treatment.,No one gets out of this world

24、 alive, and few people come through life without at least one serious illness. If we are given a serious diagnosis, it is useful to try to remain free of panic and depression. Panic can constrict the blood vessels(血管) and impose(強(qiáng)加) an additional burden on the heart. Depression, as medical researche

25、rs all the way back to Galen have observed, can set the stage for other illnesses or intensify existing ones. It is no surprise that so many patients who learn that they have cancer or heart diseaseor any other catastrophic,ktstrfk diseasecome worse at the time of diagnosis.,The moment they have a l

26、abel to attach to their symptoms, the illness deepens. All the terrible things they have heard about disease produce the kind of despair that in turn complicates the underlying（潛在的） condition. It is not unnatural to be severely apprehensive（憂慮不安） about a serious diagnosis, but a reasonable confidenc

27、e is justified（合理的）. Cancer today, for example, is largely a treatable(能治療的) disease. A heavily damaged heart can be reconditioned . （再修復(fù)）Even a positive HIV diagnosis does not necessarily mean that the illness will move into the active stage.,One of the interesting things researchers at the UCLA me

28、dical center have discovered is that the environment of medical treatment can actually be enhanced if seriously ill patients can be kept free of depression. In a project involving 75 malignant-melanoma patients, it was learned that a direct connection exists between the mental state of the patient a

29、nd the ability of the immune system to do its job.,In a condition of emotional devastation(毀壞), immune function is impaired（損害）. Conversely, liberation from depression and panic is frequently accompanied by an increase in the bodys interleukins白細(xì)胞介素， vital substances in the immune system that help a

30、ctivate cancer-killing immune cells. The wise physician, therefore, is conscious of both the physical and emotional needs of the patient.,People who have heart attacks are especially prone to despair. After they come through the emergency phase of the episode, they begin to reflect on all the things

31、 they think they will be unable to do. They wonder whether they will be able to continue at their jobs, whether they will be able to perform satisfactorily at sex, whether they can play tennis or golf again. In short, they contemplate（沉思） an existence drained of usefulness and joy. The spark goes ou

32、t of their souls.,It may help for these people to know that in addition to the miracles that modern medicine can perform, the heart can make its own bypass（旁路） around the occluded（閉塞的） arteries（動(dòng)脈） and that collateral circulation（側(cè)支循環(huán)） can provide a rich supply of oxygen. A heart attack need not be

33、regarded as consignment to a mincing life-style. Under circumstances of good nutrition, a reasonable amount of exercise and a decrease in the wear and tear of stressful events, life expectancy need not be curtailed(縮減).,Plainly（obviously）, the American people need to be re-educated about their healt

34、h. They need to know that they are the possessors of a remarkably robust mechanism. They need to be de-intimidated about disease. They need to understand the concept of a patient-physician partnership in which the best that medical science has to offer is combined with the magnificent resources of m

35、ind and body. We need not wait, of course, for a catastrophic illness before we develop confidence in our ability to rise to a serious challenge. Confidence is useful on the everyday level. We are stronger than we think. Much stronger.,Norman Cousins,Norman Cousins (Jun. 24, 1915Nov. 30, 1990) was a

36、n American political journalist, author, professor, and world peace advocate Cousins was born in Union City, New Jersey. At age 11, he was misdiagnosed(誤診) with tuberculosis and placed in a sanatorium（,sntrm 療養(yǎng)院）. Despite this, he was an athletic youth, and he claimed that as a young boy, he had “se

37、t out to discover exuberance（健康）.” Cousins attended Theodore Roosevelt High School in the Bronx, New York City, graduating on February 3, 1933. He edited the high school paper, The Square Deal, where his editing abilities were already in evidence. Cousins received a bachelors degree from Teachers Co

38、llege, Columbia University in New York City,Politically, Cousins was a tireless advocate of liberal causes, such as nuclear disarmament and world peace, which he promoted through his writings in Saturday Review. In a 1984 forum at the University of California, Berkeley entitled “Quest for Peace,” Co

39、usins recalled the long editorial he wrote on August 6, 1945, the day the United States dropped the atomic bomb in Hiroshima. Titled “The Modern Man is Obsolete,” Cousins, who stated that he felt “the deepest guilt” over the bombs use on human beings, discussed in the editorial the social and politi

40、cal implications of the atomic bomb and nuclear power. He rushed to get it published the next day in the Review, and the response was considerable, as it was reprinted in newspapers around the country, and enlarged into a book that was reprinted in different languages. In the 1950s, Cousins played a

41、 prominent role in bringing the Hiroshima Maidens, a group of twenty-five Hibakusha, to the United States for medical treatment.,He joined the staff of the New York Evening Post(now the New York Post) in 1934, and in 1935 he was hired by Current History as a book critic. He later ascended to the pos

42、ition of managing editor. He also befriended the staff of the Saturday Review of Literature(later renamed Saturday Review) Cousins received the Albert Schweitzer Prize in 1990. He died of heart failure on November 30, 1990, in Los Angeles, California, having survived years longer than his doctors pr

43、edicted: 10 years after his first heart attack, 26 years after his collagen（kldn 膠原蛋白） illness, and 36 years after his doctors first diagnosed his heart disease back,Hypochondriacs,hap()kndrk n. 憂郁癥患者 hyp憂郁 Hypochondriasis or hypochondria n. 憂郁癥；臆想病 refers to excessive preoccupation or worry about h

44、aving a serious illness.,DIAGNOSIS,A. A persistent belief, of at least six months duration, of the presence of a maximum of two serious physical diseases B. Preoccupation with the belief and the symptoms causes persistent distress or interference with personal functioning in daily living, and leads

45、the patient to seek medical treatment or investigations (or equivalent help from local healers). C. Persistent refusal to accept medical advice that there is no adequate physical cause for the symptoms or physical abnormality, except for short periods of up to a few weeks at a time immediately after

46、 or during medical investigations.,Pathogeny,1.personality Solitary, stubbornness , introversion Sensitive, self-centered, narrow-interest, 2.society and environment Friends or relatives died of diseases Improper doctors words 3.body element, physical Irrational cognition of changes in adolescence o

47、r climacterium klamktrm 4.psychological Cognitive system,諱疾忌醫(yī),扁鵲見蔡桓公，立有間，扁鵲曰：“君有疾在腠理（讀音cou，皮膚表面的紋理），不治將恐深?！被负钤唬骸肮讶藷o疾?！北怡o出，桓侯曰：“醫(yī)之好治不病以為功?！本邮?，扁鵲復(fù)見曰：“君之病在肌膚，不治將益深?！被负畈粦?yīng)。扁鵲出，桓侯又不悅。居十日，扁鵲復(fù)見曰：“君之病在腸胃，不治將益深?！被负钣植粦?yīng)。扁鵲出，桓侯又不悅。居十日，扁鵲望桓侯而還走?；负罟适谷藛栔?，扁鵲曰：“疾在腠理，湯熨（中醫(yī)用布包熱藥敷患處）之所及也；在肌膚，針石（中醫(yī)用針或石針刺穴位）之所及也；在腸胃，火齊（中

48、醫(yī)湯藥名，火齊湯）之所及也；在骨髓，司命之所屬，無奈何也。今在骨髓，臣是以無請(qǐng)也?！本游迦?，桓公體痛，使人索扁鵲，已逃秦矣，桓侯遂死。故良醫(yī)之治病也，攻之于腠理，此皆爭(zhēng)之于小者也。夫事之禍福亦有腠理之地，故曰：“圣人早從事焉?！保ü?jié)選自韓非子喻老）,treatment,If a person is ill with a medical disease such as diabetes or arthritis關(guān)節(jié)炎 , there will often be psychological consequences, such as depression. Some even report bei

49、ng suicidal. In the same way, someone with psychological issues such as depression or anxiety will sometimes experience physical manifestations(臨床表現(xiàn)) of these affective fluctuations（情感起伏）, often in the form of medically unexplained symptoms. Common symptoms include headaches; abdominal（腹部）, back, jo

50、int, rectal（直腸）pain; nausea（惡心）; fever and/or night sweats; itching（癢）; diarrhea（腹瀉）; dizziness; or balance problems. Many people with hypochondriasis accompanied by medically unexplained symptoms feel they are not understood by their physicians, and are frustrated by their doctors repeated failure

51、to provide symptom relief. Common to the different approaches to the treatment of hypochondriasis is the effort to help each patient find a better way to overcome the way his/her medically unexplained symptoms and illness concerns rule her/his life. Current research makes clear that this excessive w

52、orry can be helped by either appropriate medicine or targeted psychotherapy.,Recent scientific studies have shown that cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine and paroxetine) are effective treatment options for hypochondriasis as demons

53、trated in clinical trials.a talking therapy, helps the worrier to address and cope with bothersome physical symptoms and illness worries and is found helpful in reducing the intensity and frequency of troubling bodily symptoms. SSRIs can reduce obsessive（強(qiáng)迫性） worry through adjusting neurotransmitter

54、（神經(jīng)傳遞） levels and have been shown to be effective as treatments for anxiety and depression as well as for hypochondriasis. Another treatment that has proved effective in the treatment of hypochondriasis is exposure therapy. In one study, this was shown to be equally as effective as cognitive therapy

55、 and the improvements in condition were maintained after the study. back,The main impression,The main impression which was growing out of twelve years on the faculty of a medical school is that the No.1 health problem in the U.S. today, even more than AIDS or cancer, is that we dont know how to thin

56、k about health and illness. Mr. Boesche is still on the faculty of West college. 波?，F(xiàn)在仍是西方學(xué)院教員之一。 back,reactions,Reaction, response The reaction to the visit is different. 反應(yīng) All new fashion starts out as a reaction against existing convention .反抗抵觸 The sport requires very fast reactions反應(yīng)能力 what are

57、 the reactions to in the text? back,The result,The result is that we are becoming a nation of weaklings and hypochondriacs, a self-medicating society incapable of distinguishing between casual, everyday symptoms and those that require professional attention. weaklingn. 虛弱的人；懦怯者 self-medicating不遵醫(yī)囑，自

58、我治療 casual隨便的；非正式的；臨時(shí)的；偶然的 Translation back,addressing,Address ourselves to 著手去做 So we should address ourselves to the shortage of fresh water . 因此我們應(yīng)當(dāng)設(shè)法解決淡水的缺乏問題。 begin on ，commence on ，go about pushover易于征服或控制的人；容易打敗的對(duì)手；容易做的事情 back,be seized with,be seized with被（強(qiáng)烈的情感、愿望等）影響 bizarrebz奇異的 fact, ide

59、a, opinion, news, hope, belief appositive clause They were delighted at the news that their team had won. The rumour spread that a new school would be built here. back,former,Former president 正式用語(yǔ) Ex-wife 口語(yǔ) Former從前的，前者的；前任的 the latter former (not living) 已故的 late the late Chairman Liu Shaoqi前國(guó)家主席劉少奇the late government前任（上一屆）政府 Deceased deceased wife 已故的 back,thrust,thrust推力；刺 ，基本的(或特別引人注目的)成分(或意義) . 猛推，沖；擠；塞： He thrust his way through the crowd. 他沖過人群。 He thrust Martin aside. 他把馬丁猛推到一旁。 to thrust someone with a sword. 用劍刺某人。 back,out of this world,out of this