1 . Google is my doctor

When illustrator Scott Adams lost his voice, his doctors were confused.     1     It turned out that Scott was suffering from spasmodic dysphonia-a neurological disorder affecting the muscles to voice. With the help of Google Alerts and advice from his doctors, Scott got in touch with an expert in the US and had special surgery on his throat to cure his problem. He is now a firm believer of using the Internet for self-diagnosis.

Adams is one of an increasing number of people who have started using the Internet to get health advice. The advantages are numerous, starting of course with the obvious convenience of getting a diagnosis from the comfort of your own home.     2     But the Internet can provide a vast number of specialized experts, and Googling can help you tap in to that.

Diagnosing minor medical problems from information on the Internet can also have an impact on society’s medical costs. You can compare insect bites with Internet pictures, ask what type they are and whether they are dangerous without wasting your busy doctor’s precious time.

However, it must be said that diagnosis is tricky, and comparing your rash(疹子) with an online photo may lead you down the wrong path.     3     Doctors also take into account your medical history, state of mind, etc. So no computerized symptoms checklist can equal a complete professional assessment.

In conclusion, the Internet is a good starting point in diagnosing your health problems, but you should always consult your doctor before acting on anything you find there.     4    .

7 . This website is designed to explore how the experience, diagnosis and treatment of illness has changed over time, and to show some of the many ways illness has been understood by humans. It is our hope that you will leave the site with a broader appreciation of the relationship of medicine to culture, and an understanding that our own medical practices look different when seen in a historical context.

In exploring this site, we ask you to think of this fundamental idea: that illness, the feeling and experience of being sick, is itself a historical object. Illness and medicine are not static(静止的) phenomena. Different people in different time periods can experience, understand and treat similar groups of symptoms very differently. Cycles of fevers and chills may be identified as being a particular disease, part of a general pattern of seasonal health or an internal struggle of opposing yet complementary forces. These are more than just descriptions; they influence the actual experience of having illness, and strongly influence the treatment. A body that is out of balance feels pain in manner that is subjectively different from a body fighting a battle against an external attacker. We believe that illness changes over time. Thus, to fully understand illness, we need not just biological explanation, but also historical explanation. We need both medicine and the history of illness.

Related to this idea is a second. This is the concept that illness, and the medical responses to illness, are related to cultural worldviews. How we see the world structures how we experience and shape the world we live in. What makes particular responses seem reasonable emerges from specific cultural values. The judgements about what medical practices are effective and sensible are value judgements made in the context of broader cultural beliefs about how the world works, our place in that world, and what is morally good and bad. Our aim is to help you understand why blood-letting for instance, now considered unacceptable, was a sensible healing activity in the early 19^th century.

Finally, it is easy to read the history of medicine as one of constant progression leading from barbaric (野蛮的) roots to a scientific approaches embodied in current medical practice. We believe that this understanding is problematic. First, a lack of knowledge that we have today did not mean that medicine in other time periods and cultures was wrong. Based on cultural values and contemporary knowledge, other cultures developed advanced treatments that were effective and sensible for their people, although they may be considered barbaric nowadays. Similarly in a century or two, our own medical practices may seem backward and nonsensical, it is not the case that former practices have led simplistically to our own superior knowledge.

Finding the right doctor isn’t easy and it shouldn’t be. When you put your life in someone else’s hands, you need to feel confident that this is     1     individual with enough smarts, qualifications, and skills to give you the care you deserve. You should shop for a doctor “the same way you interview a lawyer or an accountant,” says Don Powell, president of the American Institute for Preventive Medicine, a nonprofit organization that promotes healthy behavior. He notes that you could be starting one of the most important professional relationships you ever have.

“People know more about how to buy a car     2     they do about selecting a doctor,” says Powell. It’s not so much a matter of labeling a doctor     3     “good” or “bad”—you want to go beyond just weeding out (淘汰) physicians who have gotten     4     into professional or legal hot water. It’s about comfort level, whether a particular doctor is good for you. Smart questions and a little healthy skepticism can help you find Dr. Right.

What kind of care are you looking for? A primary care doctor helps keep you healthy, provides a home base for all your medical needs, and is your go-to person when you’re sick. A specialist has a deeper but narrower skill set, and may serve only a short-term purpose, like diagnosing a problem or designing a treatment regimen (养生法). Experts suggest     5     (start) with a primary care doctor who can then help direct you to the most appropriate specialist or sub-specialist (think a cardiologist for a possible heart problem or a cardiac electrophysiologist for a heart rhythm problem), should the need arise.

After the general category of physician is roughly determined, the next step is     6     (ask) yourself what blend of experience and personality traits are important to you     7     you and the doctor will be a good fit. It’s a mix that obviously depends on the relationship you will have with the doctor.     8     it’s long-term, such as one with a primary care doctor or with a specialist who sees you for an ongoing condition, personality and behavior will carry more weight than if it’s a one- or two-time encounter with a specialist or surgeon.

A new study by a team of Stanford University School suggests that the average human body temperature in USA has decreased over the last century. The idea that the normal human body temperature is about 37°C was first     1     by a German physician in 1851. Since then, it’s become so widely accepted that it serves as a(n)     2     tool used by people as a basic indicator if someone is sick.

However, it turns out that this well-established fact is not completely correct– or, to put it more     3    , human beings have been getting cooler. Recent studies have shown that temperature records have tended to run low compared to the accepted     4    , so the Stanford team decided to do a more in-depth study to compare modern measurements with historical records to try to identify body temperature trends and     5     the reason.

The team looked at three     6     databases from three historical periods. One was the records from Union Army veterans (退伍老兵) that were collected from 1862 to 1930. The second was from the US National Health and Nutrition Examination Survey collected between 1971 and 1975, and third from adult patients visiting Stanford Health Care from 2007 to 2017.

By cross-checking the health records, the researchers concluded that the average American’s body temperature is about 0.03°C and 0.6°C lower for women and men,     7    , than it was in the 19th century.Together, this means that human body temperatures have fallen by 0.03°C per decade. However, considering that many factors influence body temperatures, the team says that it is unnecessary to     8     the definition of the average body temperature.

As for the reasons, the researchers say that the most likely one is a decline in the human metabolic rate (人体代谢速率) due to environmental factors. One possibility is that improvements in public health have reduced the incidence of inflammations (炎症感染率), which     9     metabolism. This,     10     with the fact that people live more comfortable lives in more stable environments means that the body doesn’t have to work as hard to stay warm, so the average temperature falls.

10 . Delivering life-saving drugs directly to the brain in a safe and effective way is a challenge for medical providers. One key reason: the blood-brain barrier, which protects the brain from tissue-specific drug delivery. Methods such as an injection or a pill aren't as precise or immediate as doctors might prefer, and ensuring delivery right to the brain often requires invasive, risky techniques.

A team of engineers from Washington University in St. Louis has developed a new nano-particle generation-delivery method that could someday vastly improve drug delivery to the brain, making it as simple as a sniff.

“This would be a nano-particle nasal spray, and the delivery system could allow medicine to reach the brain within 30 minutes to one hour,” said Ramesh Raliya, research scientist at the School of Engineering & Applied Science.

“The blood-brain barrier protects the brain from foreign substances in the blood that may injure the brain,” Raliya said. “But when we need to deliver something there, getting through that barrier is difficult and invasive. Our non-invasive technique can deliver drugs via nano-particles, so there's less risk and better response times.”

The novel approach is based on aerosol science and engineering principles that allow the generation of mono-disperse nano-particles, which can deposit on upper regions of the nasal cavity via spread. The nano-particles were tagged with markers, allowing the researchers to track their movement.

Next, researchers exposed locusts' antenna to the aerosol, and observed the nano-particles travel from the antennas up through the olfactory nerve, which is used to sense the smell. Due to their tiny size, the nano-particles passed through the brain-blood barrier, reaching the brain and spreading all over it in a matter of minutes.

The team tested the concept in locusts because the blood-brain barriers in the insects and humans have similarities. “The shortest and possibly the easiest path to the brain is through your nose,” said Barani Raman, associate professor of biomedical engineering. “Your nose, the olfactory bulb and then olfactory cortex: two steps and you've reached the cortex.”

To determine whether or not the foreign nano-particles disrupted normal brain function, Saha examined the physiology response of olfactory neurons in the locusts before and after the nano-particle delivery and found no noticeable change in the electro-physiological responses was detected.

This is only a beginning of a set of studies that can be performed to make nano-particle-based drug delivery approaches more principled, Raman said. The next phase of research involves fusing the gold nano-particles with various medicines, and using ultrasound to target a more precise dose to specific areas of the brain, which would be especially beneficial in brain-tumor cases.