healthandmedicine

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 promotion, 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 living. 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 increasing 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 factors affecting health,1. Acts and lifestyle factors(行为和生活方式）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, sexually transmitted diseases and AIDS, mental diseases, such as suicide and behaviour and lifestyles.行为和生活方式因素是指因自身不良行为和生活方式，直接或间接给健康带来的不利影响。如糖尿病、高血压、冠心病、结肠癌、前列腺癌、乳腺癌、肥胖症、性传播疾病和艾滋病、精神性疾病、自杀等均与行为和生活方式有关。,Affecting the health and health factors affecting almost all of the Role and conduct. such as smoking 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.行为是影响健康的重要因素，几乎所有影响健康因素的作用都与行为有关。例如吸烟与肺癌、慢性阻塞性肺病、缺血性心脏病及其他心血管疾病密切相关。酗酒、吸毒、婚外性行为等不良行为也严重危害人类健康。,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. According 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为导致了慢性非传染性疾病及性病、艾滋病的迅速增加。近年来我国恶性肿瘤、脑血管病和心血管病已占总死亡原因的61。据美国调查，只要有效地控制行为危险因素：不合理饮食、缺乏体育锻炼、吸烟、酗酒和滥用药物等，就能减少4070的早死，13的急性残疾，23的慢性残疾。,Environmental factors,Natural EnvironmentTo 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 will suffer a retaliatory nature.自然环境 保持自然环境与人类的和谐，对维护、促进健康有着十分重要的意义。若破坏了人与自然的和谐，人类社会就会遭到大自然的报复。,Environmental factors,(2)Social EnvironmentSocial Environment including legal, social, economic, cultural, education, population, ethnic, professional, social and health of the relevant policies, laws and regulations。社会环境 包括社会制度、法律、经济、文化、教育、人口、民族、职业等，社会制度确定了与健康相关的政策、法律、法规等。,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, diabetes, cancer and other diseases .生物学因素 遗传 据调查，目前全国出生婴儿缺陷总发生率为137，其中严重智力低下者每年有200万人。遗传还与高血压、糖尿病、肿瘤等疾病的发生有关。,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 well, will you go to see a doctor immediately? Why or why not?,疑邻盗斧,人有亡鈇者，意者邻之子，视其行步，窃鈇也；颜色，窃鈇也；言语，窃鈇 也；动作态度，无为而不窃鈇也。俄而抇其谷而得其鈇，他日复见其邻人之子，动作态度，无似窃鈇者。 这则寓言说明，主观成见，是认识客观真理的障碍。当人以成见去观察世界时，必然歪曲客观事物的原貌。,疑邻盗斧译文,从前有个（乡下）人，丢了一把斧子。他怀疑是邻居家的儿子偷去了，便观察那人，那人走路的样子，像是偷斧子的；看那人的脸色表情，也像是偷斧子的；听他的言谈话语，更像是偷斧子的，那人的一言一行，一举一动，无一不像偷斧子的。不久后，他（丢斧子的人）在上山的时候发现了他的斧子，第二天又见到邻居家的儿子，就觉得他言行举止没有一处像是偷斧子的人了。,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. Our 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 professional 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 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(拥挤) 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（垃圾粉粹机）, 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 life, too, we become seized with the bizarre(奇异) 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 equipped to deal with the little demons, and that the best way of forestalling(预防；囤积 ) 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 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（疾驰，撕裂） our 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 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(强加) an additional burden on the heart. Depression, as medical researchers 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 label 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（潜在的） condition. It is not unnatural to be severely apprehensive（忧虑不安） about a serious diagnosis, but a reasonable confidence is justified（合理的）. Cancer today, for example, is largely a treatable(能治疗的) disease. A heavily damaged heart can be reconditioned . （再修复）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 medical 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 and the ability of the immune system to do its job.,In a condition of emotional devastation(毁坏), immune function is impaired（损害）. Conversely, liberation from depression and panic is frequently accompanied by an increase in the bodys interleukins白细胞介素， vital substances in the immune system that help activate 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 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 out 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（闭塞的） arteries（动脉） and that collateral circulation（侧支循环） can provide a rich supply of oxygen. A heart attack need not be 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(缩减).,Plainly（obviously）, the American people need to be re-educated about their health. 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 mind 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 an American political journalist, author, professor, and world peace advocateCousins was born in Union City, New Jersey. At age 11, he was misdiagnosed(误诊) with tuberculosis and placed in a sanatorium（,sntrm 疗养院）. Despite this, he was an athletic youth, and he claimed that as a young boy, he had “set 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 College, 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,” Cousins 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 political 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 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 position 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 predicted: 10 years after his first heart attack, 26 years after his collagen（kldn 胶原蛋白） illness, and 36 years after his doctors first diagnosed his heart diseaseback,Hypochondriacs,hap()kndrk n. 忧郁症患者hyp忧郁Hypochondriasis or hypochondria n. 忧郁症；臆想病 refers to excessive preoccupation or worry about having 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 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 or during medical investigations.,Pathogeny,1.personalitySolitary, stubbornness , introversionSensitive, self-centered, narrow-interest,2.society and environmentFriends or relatives died of diseases Improper doctors words3.body element, physicalIrrational cognition of changes in adolescence or climacterium klamktrm 4.psychologicalCognitive system,讳疾忌医,扁鹊见蔡桓公，立有间，扁鹊曰：“君有疾在腠理（读音cou，皮肤表面的纹理），不治将恐深。”桓侯曰：“寡人无疾。”扁鹊出，桓侯曰：“医之好治不病以为功。”居十日，扁鹊复见曰：“君之病在肌肤，不治将益深。”桓侯不应。扁鹊出，桓侯又不悦。居十日，扁鹊复见曰：“君之病在肠胃，不治将益深。”桓侯又不应。扁鹊出，桓侯又不悦。居十日，扁鹊望桓侯而还走。桓侯故使人问之，扁鹊曰：“疾在腠理，汤熨（中医用布包热药敷患处）之所及也；在肌肤，针石（中医用针或石针刺穴位）之所及也；在肠胃，火齐（中医汤药名，火齐汤）之所及也；在骨髓，司命之所属，无奈何也。今在骨髓，臣是以无请也。”居五日，桓公体痛，使人索扁鹊，已逃秦矣，桓侯遂死。故良医之治病也，攻之于腠理，此皆争之于小者也。夫事之祸福亦有腠理之地，故曰：“圣人早从事焉。”（节选自韩非子喻老）,treatment,If a person is ill with a medical disease such as diabetes or arthritis关节炎 , there will often be psychological consequences, such as depression. Some even report being suicidal. In the same way, someone with psychological issues such as depression or anxiety will sometimes experience physical manifestations(临床表现) of these affective fluctuations（情感起伏）, often in the form of medically unexplained symptoms. Common symptoms include headaches; abdominal（腹部）, back, joint, rectal（直肠）pain; nausea（恶心）; fever and/or night sweats; itching（痒）; diarrhea（腹泻）; 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 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 worry 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 demonstrated 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（强迫性） worry through adjusting neurotransmitter（神经传递） 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 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 think about health and illness.Mr. Boesche is still on the faculty of West college.波希现在仍是西方学院教员之一。back,reactions,Reaction, responseThe reaction to the visit is different. 反应All new fashion starts out as a reaction against existing convention .反抗抵触The sport requires very fast reactions反应能力 what are 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. 虚弱的人；懦怯者self-medicating不遵医嘱，自我治疗 casual随便的；非正式的；临时的；偶然的 Translationback,addressing,Address ourselves to 着手去做So we should address ourselves to the shortage of fresh water .因此我们应当设法解决淡水的缺乏问题。begin on ，commence on ，go aboutpushover易于征服或控制的人；容易打败的对手；容易做的事情 back,be seized with,be seized with被（强烈的情感、愿望等）影响 bizarrebz奇异的 fact, idea, 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 正式用语Ex-wife 口语Former从前的，前者的；前任的 the latterformer (not living) 已故的 late the late Chairman Liu Shaoqi前国家主席刘少奇the late government前任（上一届）政府Deceased deceased wife 已故的back,thrust,thrust推力；刺 ，基本的(或特别引人注目的)成分(或意义) . 猛推，冲；挤；塞： He thrust his way through the crowd.他冲过人群。He thrust Martin aside.他把马丁猛推到一旁。to thrust someone with a sword.用剑刺某人。back,out of this world,out of this worl