的吗 The?
好吧 Well,
这是我们这门课的第一堂课关于西方科学医学 here we are at our course the first lecture of the course on Western scientific medicine.
这是西方 This is western,
它是科学 it is scientific,
它不是亚洲医学 it is not Asian medicine,
它不是我们听说过或读到过的任何神秘药物 it is not any of the mystical medicines that we've heard about and read about,
当然不是 and it's certainly not.
的选择 alternative.
在这门课上 医学坚持科学 Medicine were sticking to science during this course,
我们正在这样做 and we're doing it.
用传记作为我们的参考 Using biography is our reference point?
托马斯 卡莱尔 Thomas Carlyle,
他是早期严肃优秀的历史学家之一 who was one of the early and serious and good historians,
据说 历史是无数传记的精华 is reputed to have said that history is the essence of innumerable biographies.
他说 he said.
大约1830年 This about eighteen thirty.
好吧 Well,
如果大多数历史学家都认同这一点 if that's really true in most historians do accept it,
那么它就应该是可追踪的 then it should be able to be traceable.
历史的任何学科 历史的任何方面 历史的任何文化方面 都应该通过其最大的贡献者的生活来追溯 History should any discipline of history should any aspect of history should any cultural aspect of history should be traceable through the lives of its greatest contributors,
这就是我们要做的 and so that is essentially what we're going to do,
在这12节课中 我们将从古典开始 and during the course of these twelve lectures we will go from classical antiquity.
我的意思是公元前500年到现代生物医学 and I mean five hundred BC as early as that to modern biomedicine.
我们将从神秘主义和魔法的时代 We are going to go from a period of mysticism and magic,
打开心脏手术和器官移植 to open heart surgery and to organ transplantation.
我们将从超自然的神性到怀疑主义 we are going to go from the supernatural and the deity drenched to skepticism,
这个美丽的科学探索引领着我们 and that beautiful scientific quest that has led us.
就目前的分子医学而言 as far as the molecular medicine of this current moment.
和地理位置 and geographically,
我们将从古希腊讲到我们最伟大的前沿 we're going to go from ancient Greece to the greatest of our cutting edge,
美国医学中心 American medical centers.
所以这是这是我们将要进行的一段旅程 So this is this is quite a journey that were about to take on here.
我们将沿着医学发现的轨迹从一个国家到另一个国家 We're going to trace the path of medical discovery from country to country within a trace.
从一个文化到另一个文化 会遇到一群男人和一个女人 It from culture to culture will meet a group of men and one woman as a matter of fact,
他们是最迷人的 who were among the most fascinating.
我想说的是你在生活中 阅读中 甚至是看电影中遇到的最勇敢的人 And I might say the most daring individuals that you will ever encounter in life or in your reading or even in going to the movies.
现在他们每个人 Now each of them,
那些可爱的 those that are likable,
那些令人讨厌的 and those that are obnoxious,
那些谦虚和以自我为中心的人 those that are modest and those that are egocentric.
我相信你们不会惊讶于一些科学家以自我为中心 And I'm sure you won't be surprised to know that some scientists have been egocentric,
那些平静的和那些疯狂的 those that are serene and those that are crazed.
他们每个人都有一个独特的故事告诉我们 Each of them has a unique story to tell us.
但是所有的 But all of them,
把他们所有人团结在一起的是他们对发现的非凡热情 the thing that unites all of them together is their extraordinary zeal for discovering for discovering,
您将看到 as you'll see,
大自然的秘密是其中最伟大的秘密之一 the secrets of nature was one of the greatest of them.
十七世纪的威廉·哈维 William Harvey in the seventeenth century,
最终会被称为大自然的秘密 would eventually come to call nature's closet secrets.
还有一些美味的配菜 And there are some tasty side dishes to this stew.
这座城堡的布局堪称天才之作 This castle lay as it were of genius.
因为在我们讨论这些人的时候 Because here are some of the things that will come up as we discuss these people,
大学的兴起是他们的开端 以及他们如何影响医学教育 the rise of the university's their beginning and how they influenced medical education.
科学方法和归纳推理的出现 The appearance of the scientific method and of what we call inductive reasoning from the smaller,
个体人格对成就的影响越高 to the higher the influence of individual personality on achievement.
随着我们从一个地方到另一个地方教会的作用 每个国家的民族性格和周围文化的影响 The influence of national character and of the surrounding culture in each country as we go from place to place the role of the church.
有趣的是 Interestingly,
你可能会对它的质量感到惊讶 which may surprise you as to its quality.
并且总是遍及一切 and always pervading everything,
在探索中扮演的角色 the part that's played in discovery,
通过发现他或她所带来的心理构成 by the psychological makeup of the Discover what he or she brings,
这很奇怪 with this strange,
往往总是以独特的个性去实验室 去诊所 often always unique personality to the laboratory to the clinic,
无论它是 wherever it is.
威廉·奥斯勒 Sir William Osler?
谁可能是美国最伟大的医学教授我们称他们为美国人 Who is probably the greatest of the American medical teaches we call them American?
虽然他出生在加拿大 然后最终在英国结束了他的日子 Although he was born in Canada and then eventually finished his days in England.
但他的大部分时间是在美国的约翰霍普金斯大学度过的 But most of his time was spent here at the United States at Johns Hopkins.
威廉·奥斯勒 William Osler.
一个说我们学习历史 One said that we study history.
其他原因 Among other reasons.
因为性格对性格的无声影响 for the silent influence of character upon character,
所以 最终 So ultimately,
这门课的内容是对伟大医生的一系列性格研究 what this course becomes is a series of character studies of the great doctors.
那么让我们开始吧 So let's begin.
我们从哪里开始 And where do we begin?
很明显 我们从头开始 什么是开始 Clearly we begin at the beginning and what's the beginning?
开始是医学之父 The beginning is the father of medicine.
首先是希波克拉底本人 The beginning is Hippocrates himself,
伟大的希波克拉底 the Great Hippocrates.
当我们看 When we look.
在这位伟人留给我们的所有著作中 At all of the writings that have been left to us by this great man,
当它被称为希波克拉底语料库时 when it's called the Hippocratic corpus,
希波克拉底的著作 the Hippocratic body of writings.
我们认识到不同书籍之间的显著差异 We recognize significant differences between the various books.
它们的风格不同 they're different in style.
其中一些相互矛盾 Some of them contradict one another.
有些人只会说别人不说的话 Some of them just say things that others don't say.
他们中的一些人处理非常困难的实际问题 比如手术 Some of them deal with very hard practical stuff like surgery,
其中一些涉及到非常理论化的东西 and some of them deal with very theoretical stuff,
如道德 like ethics,
甚至道德 even morality,
宗教 religion.
所以我们发现 So we find.
听起来不太像 It doesn't really sound,
只不过它们都是用爱奥尼亚方言写的 except that they're all written in the ionic dialect.
听起来好像不是一个人一直在做 It doesn't really sound as if they were consistently done by one man,
事实证明他们不是 and it turns out that they weren't.
他们写的 They were written.
事实证明 as it turns out.
在大约两百年的时间里 Over a period of about two hundred years.
一大群男人 By a large group of men.
可能有一些女人 There may have been some women.
投稿者对此并不确定 Contributors were not sure of that,
但主要是由一大群男人 but primarily by a large group of men.
他的主要兴趣 他的主要焦点是把超自然的东西和只涉及自然的东西分开 Whose primary interest in whose primary focus was to separate that which is supernatural from that which deals only with nature.
这是自然的 他们关心的是他们的思想 而不是那些在他们之前的人 It is nature that they were concerned about their thought was as opposed to those who had come before them.
疾病是由环境中的某些因素引起的 that sickness arises out of something in the environment,
有时和他在一起 sometimes something with him,
的人 the person,
但从来没有什么是必须通过他们所信仰的诸神来解释的 but never anything that has to be explained through the various deities that they believed in.
因此 And therefore,
如果你要治疗这种疾病 if you're going to treat this illness,
它必须用自然的方法来治疗 it has to be treated using natural methods.
它不能通过诉诸神灵来解决 it cannot be treated by appealing to the deities.
这些神是谁 Who are these deities?
他们与之战斗的神灵是谁 Who are these deities that that they were fighting,
他们反对 that they were opposing,
他们推翻了 that they essentially overthrew?
这些神灵是否被一些历史学家称为医学独立宣言 Were these deities against whom they wrote what some historians have called the declaration of Independence of Medicine,
远离那些没有人真正理解疾病的可怕时光 the separation from those awful times when no one really understood illness,
它总是被描述成天上的什么东西 and it was always described to something up there in the clouds.
好 Well.
众神是一大群神 The deities were a large group of gods,
但主要是在伟大的上帝的控制下 but primarily under the control of the great God.
阿波罗 Apollo,
他也是医治的神 who is also the God of healing.
一项关于是否与她结婚的民意调查 A poll was whether married her,
不是给一个叫克罗妮丝的仙女 not to a nymph named Coronis,
他们的后裔就是这另一个神 and their offspring was said to be this other God,
他的名字叫艾斯卡勒斯伟大的治愈之神 whose name was escalates the great God of healing.
在希波克拉底医生之前 And so prior to the days of the Hippocratic physicians.
在公元前四世纪和五世纪 In the fourth and fifth century BC.
如果一个人生病了 If one was sick.
一个 One,
当然 of course,
向逐步升级的伟大上帝祈祷 said prayers to the Great God of escalate,
伟大的神 Great God,
阿斯克勒庇俄斯床 asclepius bed!
它更加正式 而不仅仅是一个祈祷的问题 It was more formalised than that it wasn't just a matter of saying prayers.
有些神庙供奉着阿斯克勒庇俄斯神的神殿它们往往是微风覆盖的山丘 太阳很容易就能到达 There were temples devoted to shrines of the God asclepius they tended to be often breeze covered hills where the sun could easily reach them;
他们靠近美丽的泉水和溪流 周围有花园 They were near beautiful springs and streams cultivated gardens surround that.
如果有神像 If there were statues of the God,
他们大概知道他长什么样 they had some idea of what he must look like,
长长的卷发垂在他的肩膀上 形成了他周围的雕像 with his long curly waves hanging down on his shoulders into statues around him,
人们可以向它祈祷 to which one could pray.
流氓牧师会唱着咒语四处游荡 Rogue priests would wander through singing incantations.
还有神圣的蛇 And there were sacred snakes,
他们相信蛇的力量 they believed in the power of snakes,
据说神拿着一根大杖 上面有一条蛇 and the God was said to hold this large staff around which a single snake,
正在愈合的蛇受伤了 the healing serpent was wound.
当然 And that is where of course,
我们今天得到了医学的象征 we get the symbol of medicine to day.
墨丘利的节 The caduceus.
还有动物祭祀 There were animal sacrifices.
最初的焦点是我们所谓的治疗性梦想 The primary focus was on what we might call the therapeutic dream.
这不是弗洛伊德的理论 This isn't a Freudian thing.
这是一个非常不同的梦想 this is a very different kind of a dream.
我们的想法是在寺庙里待上几天 然后喝上一杯 The idea was to stay in the temple for days and days and days and have a drink.
如果你能记住合适的梦境 And if you could remember the appropriate dream,
你带着它去找牧师 他会解释它 他会告诉你该怎么做才能好起来 you would come to the priest with it and he would interpret it and he would tell you what you had to do to get better.
有时他会简单地说 Sometimes he would simply say,
好吧 Well,
梦说你会在四天内变得更好 the dream says you will be better in four days,
回家接受治疗吧 Go home and be healed.
但有时情况会更复杂 But sometimes it would be more complicated than that.
他会说 He would say,
好吧 Well,
你找错工作了 you've got the wrong job.
你真的应该去塞萨洛尼基 You really ought to go to Thessaloniki.
成为一个数字赛跑者或者类似的东西 Become a number's runner or something like this.
你的工作 This job of yours.
在雅典的警察局里放羊不适合你 taking care of the sheep in the constabulary in Athens is not the right place for you,
所以去做另一件事吧 你需要一个妻子或者你的妻子需要一个孩子 so go do this other thing war you need a wife or your wife needs a child.
或者吃火腿代替猪肉 Or eat ham instead of pork,
不管是什么 whatever it might be,
他会给出这些和结构 he would give these and structure.
有时候你会说你必须净化自己 Sometimes you would say you've got to purge yourself.
吃一些可怕的药物 直到你严重腹泻 它会离开你或喝从一个特殊的流 Take some awful a medic until you're having terrible diarrhea and it will go out of you or drink from a special stream.
这是众神所说的 This is what the gods have said.
人们会这样做 And people would do there.
有些人的病情有所好转 And some people got better.
事实上 In fact,
当然 of course,
很多人都康复了 a lot of people got better,
因为我们所知道的一件关于医学的事是90%的人会变好 because one thing we do know about medicine is that ninety per cent of us get better,
不管我们做什么 regardless of what we do.
所以他们当然 so they of course,
因为人们有宗教信仰 had a reputation and because people were religious,
跟随这些不同的神 following all of these various gods,
尤其是阿波罗 especially Apollo,
是谁代表Esculapius who's representative Esculapius,
在那里 was there.
是一种巨大的暗示力量 Was this huge power of suggestion.
这不是希波克拉底医生的方式 This was not the way of the Hippocratic physicians.
我倾向于提到它们 I tend to refer to them,
当然 of course,
是希波克拉底医生 is the Hippocratic physicians.
虽然有时我又会重复希波克拉底的老一套 Although sometimes I slip into the old pattern of saying Hippocrates again,
在大约公元前400年到公元前200年的200年间 我们接触了很多人 we're dealing with a lot of people over the course of about two hundred years from about ooze four hundred to about two hundred BC.
所以 So,
就像我说的 as I say,
我会买一个大的 叫希波克拉底医生 I will buy a large call them the Hippocratic physicians.
但偶尔 But once once in a while,
我会说 I'll say,
那希波克拉底呢 Hippocrates What about Hippocrates,
希波克拉底的真正崛起 the really rise of Hippocrates.
我们对他一无所知 We don't know anything about him.
我们只知道 We know only.
他的父亲名叫赫拉克利特 That his father was named Heraclitus.
他是一名世袭的埃斯库拉皮医生 He was a hereditary esculapian physician.
它们往往是遗传的 They did tend to be hereditary.
希波克拉底生于公元460年 He Hippocrates was born in four sixty.
B B.
在一个叫cosc的小岛上 C on a little island named COS C O s,
在现在土耳其的西南海岸外 which is off the southwest coast of what is now Turkey,
那里有一座巨大的埃斯库拉皮亚神庙 where there was a large esculapian temple.
为了让你们了解这个人出现的激动人心的时刻 Just to give you some idea of the exciting time in which this man made his appearance,
这就是我们所说的希腊的黄金时代 it was what we call the golden age of Greece.
这是伯里克利时代 It was the age of Pericles,
欧里庇得斯 Euripides,
埃斯库罗斯 Aeschylus,
索福克勒斯阿里斯托芬 Sophocles Aristophanes.
他出生时苏格拉底还活着 He was born when Socrates was still alive.
他的一生跨越了柏拉图的整个一生 His life spanned the entire life of Plato.
在亚里士多德的早期 他至少活了10年 And he lived for at least a decade during the early years of Aristotle.
所以这是最好的时间这是我们阅读和学习经典的时间 So this is the best time this is the time we all read about and study in our classics.
课程 courses.
但就是这样 But that's it.
我们只知道 We know only beyond that,
他是个巡回医生 that he was an itinerant physician,
这些希波克拉底式的医生 as all of these Hippocratic physicians were somehow,
我们不知道他们是怎么走到一起的 and we don't know how they came together,
可能是从成本岛开始的 最终迁移到希腊半岛 并在这个庞大的希腊帝国中找到了自己的道路 probably started on that island of costs and eventually migrated onto the Greek Peninsula and found their way all over this enormity of a Greek empire.
他们给我们留下了什么 What did they leave us?
这就是所谓的希波克拉底语料库 this socalled Hippocratic Corpus,
这个知识体系 this body of knowledge?
它来自哪里 Where does it come from?
是谁写的好 What was it who wrote it Well,
我已经说过了 as I've said,
是谁写的 it was written by?
这些人的群体有时是个体 有时是群体 Groups of these men sometimes individual sometimes groups.
这是思想 it is thought.
这是在那个岛上发现的图书馆的遗迹 That it is the remains of a library that was found on that island.
还有人认为 其中相当一部分最终被转移到了亚历山大的大图书馆 And it's also thought that a good part of it was eventually transferred to the great library in Alexandria.
那 That,
如你所知 as you know,
最终被摧毁 was eventually destroyed.
由吗 Consists of?
70种不同的文本 Of seventy different texts,
他们是真正意义上的杂色 they are in the true sense of variegated.
它们覆盖了整个空间 They just cover this entire span.
多年来 Over the years,
正如历史学家所研究的那样 as historians have studied them,
尤其是在19世纪 especially during the nineteenth century,
当有很多人对学习感兴趣的时候 when there was a lot of interest in studying,
希波克拉底 Hippocrates.
他们得出的结论是 A conclusion was reached that there were certain of them,
具有特别高的道德或伦理价值 which had particularly high moral or ethical value,
或者它们在理解疾病过程和某些医学历史学家方面特别有用 or they were particularly useful in understanding the disease process and somebody or other some medical historian.
虽然他们在19世纪早期不是正式的医学历史学家 Although they weren't formal medical historians in the early nineteenth century,
有人在研究这些东西叫做作品 someone who was working on these things called those works,
真正的希波克拉底的作品 the genuine works of Hippocrates.
今天你可以去古董书店买到这些起源于1850年的书 And today you can go to an antiquarian bookstore and get one of these books that originated in eighteen fifty,
1860年被称为希波克拉底的真正作品 one thousand eight hundred and sixty called The Genuine Works of Hippocrates.
V V.
矿石 Ore.
那些真正的 Those genuine ones,
以特别清晰的思想而著称 distinguished by a particular clarity of thought.
通过一个崇高的道德信息 他们每一个人 By a high moral message and every one of them,
通过我们只能称之为科学客观性的东西 by what we can only call a scientific objectivity,
你又让这些作家后退了一步 you're stepping back these writers again.
他们拿走了任何超自然的概念 只使用自己的个人观察 They're taking away any notion of the supernatural and there looking only to use their own personal observations,
他们会一遍又一遍地录下来 然后教给他们的学生 which they would record again and again and again and teach to their students.
这就是我们在这些真正的作品中发现的 And that's what we find in these genuine works.
但是其他的书也有这个 But the rest of the books have this as well.
最著名的书之一 One of the most famous books,
当人们只拥有一本希波克拉底的著作时 and when people own nothing more than one volume of Hippocrates,
他们所拥有的是一本书叫做希波克拉底的格言简洁的格言 what they tend to own is a book called The Aphorisms of Hippocrates Pithy Sententious clear,
一个人的陈述 直到她不得不照顾生病的人 如何过一个高尚的道德生活 an individual statements till she had to take care of sick people and how to live a high moral life.
在这几百条警句中 And of all of those hundreds of aphorisms,
首先从希腊语翻译成拉丁语 which were first translated into Latin from the Greek,
然后是希伯来语和阿拉伯语 and then into Hebrew and Arabic.
当然 And of course,
现在我们有了他们所有人的英语版本 now we have them in English of all of them.
其中最著名的是第一句格言因为它为这些人在他们存在的几百年里所做的一切奠定了基础 The one that's most famous is the very first aphorism because it sets the stage for virtually everything that these people did over the several hundred years that they are in existence.
我读给你们听 And I'll read it to you.
生命是短暂的 Life is short.
艺术是恒久的 机会是瞬息即逝的 The art is long opportunity is fleeting.
经验是不现实的 experience is delusive,
判断是困难的 judgement is difficult,
他们称之为医学的艺术 the art they called medicine,
艺术 the art,
今天的医学艺术告诉你它是科学它永远不会成为科学 the art of medicine are people today who tell you that its science it's never going to be a science.
它确实是一门运用科学的艺术 It is indeed an art that uses science,
我认为他们意识到 无论什么时候翻译希波克拉底著作中的艺术这个词 都是将其与其他形式的艺术和技巧区分开来的资本 and I think they recognize that whenever it's translated that word art from the various Hippocratic writings is always a capital a on it to distinguish it from other forms of art and artifice.
所以生命是短暂的 So life is short.
这位艺术家 The artist law.
没有一个医生能够学到他或她一生中需要学习的东西 no doctor can learn what he or she needs to learn in a lifetime.
这就是机会所在 That's the point of that opportunity.
短暂的 Fleeting.
病人在他或她患病的特定时间来找我们 A patient comes to us at a particular time in his or her disease.
这是一个诊断和治疗病人的小机会 There's a small opportunity to make that diagnosis and cure that patient.
如果他在那之前来 If he comes before that time,
很难做出诊断 it's hard to make the diagnosis.
它在那个时间之后 It comes after that time.
我们诊断得太晚了 And we make the diagnose too late.
我们对此无能为力 We can't do anything about it.
经验属于露西 Experience is to Lucy.
每个医生都喜欢旋转 Every doctor likes they whirl.
根据我的经验 In my experience,
事实上 任何一个医生的经验都是虚幻的 where the fact of the matter is that any individual doctor's experience is delusive.
他们可以欺骗他或她 they can fool him or her.
所以我们现在使用的统计数据在现代医学中很重要 So we use statistics nowadays that's the big thing in modern medicine,
当然 of course,
除了分子生物学 other than molecular biology.
但是 But what,
毕竟 after all,
统计数据除了成千上万的病人和医生的综合经验之外还有所有固有的错误吗 are statistics except the combined experiences of thousands and thousands of patients and doctors with all of the errors that are inherent in that way of looking at experience?
因为 because,
当然 of course,
每个人都是不同的 这是广泛的链球菌喉炎青霉素 every person is always different from every other person which is wide penicillin for strep throat.
我们99%的时间都在工作 We'll work ninety nine point eight per cent of the time,
但总会有0 2%的人 but there will always be two tenths of one per cent of people,
对那些没用的人来说 for whom it doesn't work,
更不用说癌症的治疗方法了 not to mention the therapies for cancer,
等等 and so on.
他们当然没有这样的良好记录 that certainly don't have good records like that,
所以经历了虚幻的判断 so experiences delusive judgment.
最难的判断是最困难的事情 difficult judgment is the most difficult thing of all.
这就是医生的工作 That's what doctors do.
这就是为什么他们坐在床边 That's why they sit at the bedside.
它不需要像我这样的人 It doesn't take someone like me,
例如 for example,
培训一名外科医生需要8年 因为我在技术方面培训他需要8年 eight years to train a surgeon because I'm training him in technical things takes eight years.
因为他或她必须学会判断什么时候该做什么时候不该做 Because he or she has to learn judgment when to operate when not to operate,
如何了解疾病 什么时候去看医生 how to understand the disease when to get a consultation.
这个疾病最终的前景是什么 What the outlook is eventually going to be in this disease.
医学之父 So the Father of Medicine,
希波克拉底或者其他什么人第一次告诉我们这个 第一次指出这个 Hippocrates or whoever they were first told us this and first pointed it out now.
希波克拉底医学的一些原则是什么 what is some of the principles of Hippocratic medicine?
改变过去的原则又一次出现了吗 The principles that changed what had come before once again?
疾病 Diseases.
我们的活动 Our events.
不发生 That don't happen.
除非是在一个人的一生中 Except within the entire life of an individual.
所以 So,
与今天不同 unlike today,
我们医生倾向于想到一种疾病而带来疾病的病人他们想到的是整个病人 we're physicians tend to think of a disease and the patient who brings the disease they thought of the entire patient.
当他们治疗 When they treated,
他们治疗了整个病人 they treated the entire patient.
大自然需要维持一种平衡状态 Nature needs to maintain a condition of equilibrium.
这就是他们所相信的 That's what they believe.
身体内部有一种平衡 There's an equilibrium within the body,
它必须被维持 维持它的方法之一就是他们所说的需要热量 it must be maintained and part of the way of maintaining it is with what they called a need heat.
身体的热量是由心脏产生的 The heat of the body is generated within the heart.
所以我们的情况是必须保持平衡 如果有任何东西失去平衡 So we have a situation in which there has to be balanced and if anything gets out of balance,
这个人生病了 the person gets sick.
一组四种液体的平衡是多少 What is the balance of it is of a group of four fluids.
这四种液体的概念实际上是从埃及和早期医学中继承下来的 This idea of the four fluids had actually been inherited from Egyptian and earlier medicine,
但他们把它编成了自己的法典 but they codify it theirs.
血 Blood,
黄胆汁 yellow bile,
黑胆汁和痰是这四种液体 black bile and phlegm those are the four fluids.
我们每个人都有一个特定的性格基于我们有多少血液 Every one of us has a particular personality in a particular character based on how much blood we have,
我们有多少胆汁 how much bile we have,
我们有多少痰 how much phlegm we have.
所有这一切吗 All of this?
如果我们有很多血 If we have a lot of blood,
我们往往充满活力 we tend to be filled with energy.
我们都是乐观的拉丁词宋乐观的性格 We are sanguine the Latin word song sanguine personality.
大量的黄肠 A lot of yellow bowel,
或者我们正在建造这个 or we are building this.
我们很快就会激怒黑胆汁的毛拉们 we are quick to anger black bile mullahs,
冷静地用希腊黑色胆汁表示忧郁 coolly in Greek black bile melancholic.
如果你吃得太多 If you've got too much of that,
你有忧郁的性格 粘液来自于你的大脑 you have a melancholic disposition phlegm comes from the brain you make too much of it,
你失去了一些大脑 you lose some of your brain.
你冷漠的 you have phlegmatic.
这就是我们的单词的来源 So that's where our words come from.
它们来自于希腊关于这些特殊液体的概念 They come from the Greek notions of these particular fluids.
当然 And of course,
有些液体在夏天很热 some of those fluids are hot in summer cold,
这是它们的混合 and it was the mixture of them.
也就是说 That is,
我说的 I say,
主要的个性和性格 major personality and character.
如果他们不正常 and if they went out of whack,
如果有一个或另一个 if there was one or another,
太过分了 that was too much.
我们生病了 We got sick.
另一个基本原则 And the other basic principle,
或者另一个基本原则 or one of the other basic principles,
就是人体会自行痊愈 was that the human body tends to heal itself.
希波克拉底医学的诀窍是从希腊语翻译过来的 So the trick Hippocratic Medicine was an expression that translated from the Greek,
拉丁语是高级的 and the Latin was premium,
不是雪利酒 not sherry.
先对人无害先对人无害 Do no harm in treating people first do no harm.
那么他们是怎么做到的呢 So how did they go about this?
它们是怎样爬到树上的 How did they go about their tree?
首先 他们把准确的笔记传给学生 The first place they kept accurate notes and they pass them on to their students.
他们研究了温度变化 They looked at temperature change,
肤色 color of the skin,
面部表情 facial expression,
皮肤的外观 skin appearance.
他们拿走了历史 They took the history,
他们观察了病人的腹部轮廓 they looked at abdominal contours,
他们观察头发和指甲 闻尿液 尝尿液 they looked at hair and nails they smelt and tasted the urine.
他们尝到了耳蜡和汗水的味道 they tasted the ear wax and sweat.
因为任何这些体液失去平衡的迹象都是它的酸味 for any signs that these humors were out of balance was its sour.
是它的套房比它应该的更热 was its suite was a hotter than it should be.
还冷吗 Was it cooler?
他们测量了脉搏 They took the pulse,
不是在时间上 not in the sense of timing.
那个脉搏的强度和质量可以告诉他他们需要知道什么 The strength of the quality something about that pulse could tell him what they needed to know.
一切都必须看得见 Everything had to be observable.
你不允许想象任何东西 You were not allowed to imagine anything.
观察是关键 Observation was the key,
而且 and,
就像我说的 这一切都被记录下来了 和其他学生一起可以教好 as I say it was all recorded recorded with other students could be taught well.
自然在这个系统中是如何治愈的 医生又如何帮助自然治愈 How does nature cure in this system and how can the doctor helped nature cure?
他们相信 自然总是试图摆脱多余的幽默 They believed that nature tried always to get rid of the excess humor.
如果你有上呼吸道疾病 So if you had an upper respiratory disease,
你可以看到大量的痰从你的鼻子和嘴巴里冒出来 you could observe the enormous amount of phlegm that was coming out of your nose and mouth.
如果你患有肺结核 or if you had tuberculosis,
这在当时并不是一种罕见的疾病 也不是其他肺炎类型的疾病之一 not an uncommon disease at that time or one of the other pneumonia type diseases.
他们会看到痰在咳嗽 They'd see that phlegm coughing.
腹泻可以是黄胆汁或黑胆汁 Diarrhoea could be either yellow bile or black bile,
取决于诊断结果 depending on what the diagnosis had been.
肥皂 Soap.
问题是大自然试图排除多余的物质 The trick was that nature was trying to expel the excessive material,
但是医生不得不帮忙 but the doctor had to help.
如果病人发烧了 now if a patient had a fever,
如果他的皮肤很热 if his skin was hot,
如果他的脉搏快的话 if his pulse was fast.
很明显 Clearly,
你得除掉什么血 you'd have to get rid of what blood,
当然 of course,
所以他们会打开静脉 留下血液 so they would open up a vein and they've left the blood.
倒 Pour out,
试图摆脱这种过度的幽默 trying to get rid of this excessive humor,
这是血液 所以他们使用泻药或催吐剂浴 which was blood so they used purgatives or emetics baths,
湿敷任何会把热量带到表面的东西 wet poultices anything that would bring heat to the surface.
事实上 他们会裁员 They would cut people as a matter of fact.
放血是一件大事 Bloodletting was a major thing,
但在他们进行这些治疗之前 but before they went into any of these treatments,
多年来被称为英雄疗法 这并不奇怪 which over the years have come to be called not surprisingly heroic treatments,
他们会尝试改变饮食 they would try to change diet.
他们会给人们换一些淡而无味的饮料 就像当年的电梯一样 they would give people bland drinks change where they lived like the escalations had done,
但是他们会直接去尝试摆脱这种幽默 but then they would go right to it and try to get rid of this humor.
这些医生的另一个特点是他们对预后的概念 因为他们有如此准确的记录 Another characteristic of these physicians was their notion of prognosis because they kept such accurate records.
他们是第一批能够告诉你你会活下去的医生 they were the first doctors to be able to tell you you're going to live.
当你在第五天好起来的时候 你就会死去 你是认真的 你是对的 you're going to die when you get better on the fifth day and really mean it and really be right.
这不像自动扶梯 This wasn't like the escalators,
印度人通过他们的头脑或祈祷找到了答案 Indians who figured it out in their heads or by prayer.
他们对所研究的每一种疾病都有充分的了解 所以当他们看到你的时候 They knew enough about each individual disease they studied so that when they saw you,
他们能够预测将要发生的事情因为他们对疾病有高度发达的知识 they could predict what was going to happen because they had this highly developed knowledge of disease.
这对他们有什么用呢 And what does that do for them?
我给了他们声誉 I gave them reputation.
声誉对于希波克拉底医生来说是很重要的 reputation was an important thing for Hippocratic physicians,
因为他们是流动的 because they were itinerant,
他们需要谋生 and they needed to make a living.
你想通过流动医生来谋生吗 What would you want to make a living in your an itinerant doctor?
人们必须记住两年前这个人在这里的时候 People have to remember when this man was here two years ago,
他告诉我要一份阅读书单 上面写着他发烧时的黄疸病将在七周内消失 我的天哪 它消失了 he told I ask a reading list that this jaundice in his fever would go away in seven weeks and my God it did.
当医生们看到他时 When the escalation doctors saw him,
他说三天 he said three days,
但这并没有发生 and it didn't happen.
声誉对希波克拉底医生非常重要 人们开始意识到他们与其他医生不同 Reputation was very important for the Hippocratic physicians and people began to understand that they were different from other doctors.
所以当你知道一个希波克拉底来到你的领域 So when you knew a Hippocratic was coming to your area.
他是你最可能去找的人 he was the one you were most likely to go to,
这也是为什么很多年轻人去希波克拉底的学校学习希波克拉底的方法 which was one of the reasons that so many young man went to the Hippocratic schools and learned Hippocratic methods.
因为这真的是一种很好的谋生方式 Because it was really a good way to make a living.
除了道德 In addition to the fact that the morality.
吸引了很多人 Appealed to a large number of them,
他们做手术 they did surgery,
他们用夹板固定住骨折 they splinted fractures,
他们 they.
血和脓 Blood and pus,
棋手受伤后 head of chess after an injury,
胸腔里可能有很多血和脓 there might be a lot of blood and pus in a chest.
他们发明了针来做这个 They develop needles to do that.
如果他们认为受伤后血已经在头骨中积聚 If they thought blood had accumulated in the skull after an injury,
它们会在头骨上钻出小洞 they would make little holes in the skull,
就像埃及人在成百上千年前所做的那样 just as the Egyptians had done hundreds and thousands of years before,
他们成为了使用双手的专家 and they became experts in the use of their hands.
希波克拉底的一些文学作品充满了告诉人们一些小事 比如如何移动你的手指 Some of the Hippocratic literature is filled with telling people little things like how to move your fingers.
当你在做这些操作的时候 When you're doing one of these operations,
甚至还有一节教你如何修剪指甲 这样指甲就不会太过突出 there's even a section how to cut your nails so they shouldn't project too far off the ends of your fingers and.
所以他们非常实际 So they were very practical,
除了理论性和 in addition to being theoretical and,
当然 of course,
这项工作最理论化的部分是他们的道德准则 the most theoretical part of that work was their code of ethics,
这是西方医学伦理学的开端 which was the beginning of Western medical ethics.
为什么要制定道德规范 Why a code of ethics?
好吧 Well,
再一次 once again,
它设置了这个Dr it set this Dr.
除了其他医生 Apart from all other doctors,
他不会利用自己的地位 he was not going to take advantage of his position to,
比方说 let's say,
引诱家庭中的女性成员 seduce a female member of the household.
他不会到处跑 He was not going to run around,
告诉每个人来找他的病人的秘密 telling everybody the secrets of any patient who had come to him.
你可以相信他会做那件事 You can depend on him to do that.
伦理主要体现在 大誓言 中 Ethics were expressed primarily in the great oath,
希波克拉底的伟大誓言 the great oath of Hippocrates,
这是一件很有趣的事情 因为它有两部分 道德规范中的契约 which is an interesting thing because it has two parts the covenant in the ethical code.
约在一开始 The covenant is at the very beginning,
如果你仔细观察 and if you look at it carefully,
你看他在肿胀 you see he is swelling.
阿波罗 埃斯克勒庇俄斯 埃斯克勒庇俄斯和他的女儿们所创造的医生 The physician by Apollo by Esculapius by hygiene and panacea aesculapius his daughters to uphold this ethical code at the end of it,
他说 he says,
如果我不这么做 If I don't do this,
也许我出了什么事 may something bad happened to me.
如果我这么做了 if I do it,
祝我好运 may something good happened to me,
但其余的都是道德准则 but the rest of it is an ethical code.
这是一个专业社会的基本规则 There are the ground rules of a professional society,
它们是贯穿整个希波克拉底语料库的伦理原则 and they are the ethical principles that permeate the entire Hippocratic corpus.
我不会帮助任何人自杀 I will not help any one commit suicide.
我不会给一个女人任何无效的治疗 I will not give any abortive remedy to a woman.
我决不当石头砍 I will not cut for stone.
在那些日子里 In those days.
切割膀胱结石的死亡率非常高 Cutting for bladder stones had a hugely high mortality.
这是非常危险的 It was very dangerous.
有很多很多的并发症 there were many many complications,
所以希波克拉底医生远离它 so the Hippocratic physician stayed away from it.
但最重要的是 But most importantly,
在这段代码 in that code.
哪里有税务问题 Where matters of tax?
与耐心 With patience,
个人道德问题 matters of personal morality,
保密事宜及 matters of confidentiality and,
就像我说的 as I say,
从来没有 never ever,
医生利用的可能性或津贴 the possibility or the allowance of a doctor taking advantage.
他的位置 Of his position.
最近有一些争论 There have been arguments most recently about.
这是什么意思 What does this mean?
专制的医生绝不会开致命的药 Autocratic physician would never give deadly medicine.
在今天关于协助自杀的辩论中 这对我们意味着什么 What does that mean to us today in the debates about assisted suicide?
当然 Of course,
这是另一天的讨论 that's a discussion for yet another day,
但这是一个有趣的讨论 but it's a fascinating discussion.
当他说我不会为堕胎提供任何救济时 这意味着什么 What does it mean when he says I will give no remedy to produce an abortion?
在Roe案件的今天 In this day of Roe?
V韦德 V Wade,
今天的医学伦理学家争论的另一个论点是什么 another argument that today's current medical ethicists argue over?
为什么希波克拉底著作要把这个放在誓言里 Why did the Hippocratic works put this in their oath?
但重要的是 这是医学史上的第一次 But what's important is that for the very first time in the history of medicine,
约三百 about three hundred,
公元前352年 three hundred and fifty two hundred one hundred BC,
我们有道德准则 we have an ethical code.
大脑 Brains,
医生们聚集在一起 并将这群医生与其他医生区分开来 doctors together and marks this group of doctors as being different from all others.
这成为了流传下来的道德准则 and this becomes the ethical code that is carried down.
成为医生的年轻人对此深信不疑 The young people becoming doctors swore to it.
今天成为医生的年轻人仍然坚信这一点 Young people becoming doctors today still swear to it.
对我来说 To me,
整个希波克拉底语料库在宣誓中没有的两句话中得到了例证 the whole Hippocratic corpus is exemplified in two statements that are not in the oath,
但那是在它的其他部分 but that are in other parts of it.
我读给你们听 And I read those to you.
带着纯洁和圣洁 With purity and holiness,
我将通过我的生活和实践 I will pass my life and practice.
我的艺术就是 my art is one,
在 戒律 中 and then in the book of precepts,
哪里有人类的爱 where there is love of humankind,
只要有人类的爱 我就是最伟大的 Mr Me is the greatest of all where there is love of humankind.
还有很多医学艺术 There is also a lot of the art of medicine.