1 . 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 19th 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.
1. According to the first paragraph, the website is intended to show that ________.| A．many illnesses were wrongly diagnosed in the past |
| B．we have unrealistic expectations of medical practice |
| C．medicine should be examined in connection with culture |
| D．changes in living conditions have led to the development of new illnesses |
| A．we need more accurate biological explanations of illnesses |
| B．illnesses are influenced by climate and environment |
| C．our bodies are constantly under attack from illnesses |
| D．how an illness is interpreted affects how it is experienced |
| A．In certain cultures, the factual basis of illnesses is not recognized |
| B．Medical practices have improved over time. |
| C．Illness can influence our perception of the world. |
| D．We judge past medical practices by inappropriate principles. |
| A．There are considerable differences between cultures. |
| B．Illnesses are better understood today than in the past. |
| C．Current medical practices will be seen differently in the future. |
| D．Little research is being carried out into the treatment of some diseases. |
2 . For nearly three decades, we have waited anxiously for an effective drug that could defeat Alzheimer’s disease. We believed we had identified the root cause behind this debilitating condition: sticky clumps of the protein beta-amyloid (β淀粉样蛋白) in the brain. Even as drug after drug homing in on this target failed to make a difference to symptoms, we continued to pour more money into the effort.
Regrettably, it is now becoming clear that this time could have been better spent zooming out (缩放) from beta-amyloid, to look at the big picture of possible Alzheimer’s causes.
Doing so reveals a far more complicated and dangerous illness. It seems to be a condition that doesn’t have a lone underlying trigger, but instead results from multiple overlapping processes and risk factors.
By thinking of Alzheimer’s in the same way as we do varied conditions like heart disease, researchers are now combining knowledge from across disciplines to identify, and tackle, the many known risk factors.
This new approach comes not a moment too soon, because 10 million new cases of dementia (痴呆) are diagnosed globally each year. The vast majority of these, between 60 and 70 per cent, are Alzheimer’s disease. As people are living longer than ever, the number of people living with dementia is predicted to almost double every 20 years.
Accepting that Alzheimer’s is more complicated than we thought might seem disheartening. And yet, targeting the many factors implicated in the disease, including the role of infections, diet, sleep habits and inflammation, puts at least some control back in our own hands, because these are things we can all do something about. It means we don’t have to simply wait for pharmaceutical companies to deliver: we can also cut our own chances of getting dementia.
Tunnel vision has held us back for too long. With this new approach, a single effective drug might well be out of the picture, but instead, there is a real possibility that we could dismantle Alzheimer’s by a thousand tiny cuts.
1. We can learn from the first and second paragraphs that the author believes that ______.| A．there will be one effective drug that can cure Alzheimer’s disease |
| B．the protein beta-amyloid has nothing to do with Alzheimer’s disease |
| C．developing an effective drug was worth our money and efforts |
| D．we have been focusing on a single cause for far too long |
| A．emphasize that we should attach great importance to tackling Alzheimer’s disease |
| B．explain the unexpected difficulty in identifying the causes of Alzheimer’s disease |
| C．illustrate that the causes of Alzheimer’s disease are various and interdisciplinary |
| D．predict that Alzheimer’s disease will be cured in the same way as the heart disease |
| A．research into | B．break down | C．look down | D．inquire into |
| A．There will be a drug developed to defeat Alzheimer’s in the future. |
| B．The growing severity of Alzheimer’s is beyond people’s expectations. |
| C．People should rely on themselves instead of drugs to deal with diseases. |
| D．Zooming out for a big picture helps to lower the risks of getting Alzheimer’s. |
3 . 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.
1. This passage is mainly about ________.| A．a novel method of drug delivery | B．a challenge facing medical staff |
| C．a new medicine treating brain disease | D．a technique to improve doctor's ability |
| A．Doctors prefer using methods like an injection to treat diseases. |
| B．Locusts were tagged with markers to track their movement. |
| C．The blood-brain barrier lowers the effectiveness of a pill. |
| D．The medicine could reach the brain within half an hour. |
| A．human and locusts have similar structures that protect brain from foreign substances |
| B．the delivery process consists of the olfactory bulb and the olfactory cortex |
| C．locusts have changeable electrophysiological responses to nanoparticles |
| D．The shortest and possibly the safest path to the brain is through human's noses |
| A．A lung cancer patient who needs operation immediately |
| B．A college student who majors in medical technology |
| C．A senior doctor who is about to retire |
| D．A high school teacher who is teaching biology |
4 . 
WHO IS LIPITOR FOR?
Who can take LIPITOR:
• People who cannot lower their cholesterol (胆固醇) enough with diet and exercise
• Adults and children over 10
Who should NOT take LIPITOR:
• Women who are pregnant, may be pregnant, or may become pregnant. LIPITOR may harm your unborn baby. If you become pregnant, stop LIPITOR and call your doctor right away
• Women who are breast-feeding. LIPITOR can pass into your breast milk and may harm your baby
• People with liver problems or allergic (过敏的) to anything in LIPITOR
HOW TO TAKE LIPITOR
Do:
• Take LIPITOR at any time of day, with or without food
• If you miss a dose, take it as soon as you remember. But if it has been more than 12 hours since your missed dose, wait. Take the next dose at your regular time
Don’t:
• Do not change or stop your dose before talking to your doctor
• Do not give your LIPITOR to other people. It may harm them even if your problems are the same
POSSIBLE SIDE EFFECTS OF LIPITOR
Serious side effects in a small number of people:
• Muscle problems that can lead to kidney problems, including kidney failure. Your chance for muscle problem is higher if you take certain other medicines with LIPITOR
• Liver problems. Your doctor may do blood tests to check your liver before you start LIPITOR and while you are taking it
Call your doctor right away if you have:
• Unexplained muscle weakness or pain, especially if you have a fever or feel very tired
• Allergic reactions including swelling (肿胀) of the face, lips, tongue, and/or throat that may cause difficulty in breathing or swallowing which may require treatment right away
• Nausea, vomiting (呕吐) or stomach pain
• Feeling more tired than usual
• Your skin and whites of your eyes turn yellow
• Allergic skin reactions
Common side effects of LIPITOR are:
• Diarrhea (腹泻)
• Muscle and joint pain
• Upset stomach
• Changes in some blood tests
NEED MORE INFORMATION?
• Ask your doctor or health care provider
• Go to www.lipitor.com
1. LIPITOR is a medicine ________.
| A．specially designed for young kids | B．to cure serious liver problems |
| C．that can lower the risk for heart attack | D．for mothers-to-be to lower cholesterol |
| A．Drinking alcohol twice a day. | B．Changes in medical tests. |
| C．Discomfort and ache in muscles. | D．Feeling tired after a day’s work. |
| A．LIPITOR should never be taken with other food at the same time. |
| B．Skipping is the best choice for those who have missed one dose. |
| C．Recommendation is encouraged if one feels LIPITOR to be good. |
| D．People can consult the professionals for details of the medicine. |
5 . Over the last decade, demand for the cosmetic surgery has increased by more than 400 percent. According to Dr. Dai Davies, of the Plastic Surgery Partnership in Hammersmith, the majority of cosmetic surgery patients are not chasing physical perfection. Rather, they are driven to improve their appearance by a desire to look normal. “What we all crave is to look normal. The advertising media give us a perception(概念)of what is physically acceptable and we feel we must look like that.”
In America, the debate is no longer about whether surgery is normal; rather, it centres on what age people should be before going under the knife. New York surgeon Dr. Gerard Imber recommends “maintenance” work for people in their thirties. “The idea of waiting until one needs a heroic transformation is silly,” he says. “By then, you've wasted 20 great years of your life and allowed things to get out of hand.” Dr. Imber draws the line at operating on people who are under 18, however. “It seems that someone we don't consider old enough to order a drink shouldn't be considering plastic surgery.”
In the U. K. cosmetic surgery has long been seen as the exclusive domain(领土)of the very rich and famous. But the cost of treatment has fallen considerably, bringing all but the most advanced laser technology within the reach of most people. Dr. Davies says, “Of course, ￡3,000 for an operation is a lot of money. But it is also an investment for life which costs about half the price of a good family holiday.”
Dr. Davies suspects that the increasing sophistication(精密)of the fat injecting and removal techniques that allow patients to be treated with a local anesthetic(麻醉)in an afternoon has also helped promote the popularity of cosmetic surgery. One woman who recently paid f2, 500 for liposuction to remove fat from her thighs admitted, “Going into the clinic was so low key and effective that it whetted my appetite. Now I don't think there's any operation that I would rule out having if I could afford it.”
1. The statement “draws the line at operating on people” (Paragraph 2) is closest in meaning to ________.| A．removing wrinkles from the face | B．helping people make up |
| C．enjoying operating | D．refusing to operate |
| A．cosmetic surgery, though costly, is worth having |
| B．cosmetic surgery is too expensive |
| C．cosmetic surgery is necessary even for the average person |
| D．cosmetic surgery is mainly for the rich and famous |
| A．it is wise to have cosmetic surgery under 18 |
| B．cosmetic surgery is now much easier |
| C．people tend to abuse cosmetic surgery |
| D．the earlier people have cosmetic surgery, the better they will be |
| A．the advantage of having cosmetic surgery |
| B．what kind of people should have cosmetic surgery. |
| C．the reason why cosmetic surgery is so popular. |
| D．the disadvantage of having cosmetic surgery |
6 . Patient data: we need a better approach
Any fair-minded assessment of the dangers of the deal between Britain’s National Health Service (NHS) and Deep-Mind must start by acknowledging that both sides mean well. Deep-Mind is one of the leading artificial intelligence (AI) companies in the world. The potential of this work applied to healthcare is very great, but it could also lead to further concentration of power in the tech giants. It is against that background that the information commissioner, Elizabeth Denham, has issued her judgment against the Royal Free hospital under the NHS, which handed over to Deep-Mind the records of 1.6 million patients in 2015. This is on the basis of a vague agreement which took far too little account of the patient’s rights and their expectations of privacy.
Deep-Mind has almost apologized. The NHS has modified its ways. Further arrangements and there maybe many between the NHS and Deep-Mind will be carefully inspected to ensure that all necessary permissions have been asked of patients and all unnecessary data has been cleaned. There are lessons to learn about the informed patient agreement. But privacy is not the only angle in this case and not even the most important. Ms Denham chose to concentrate the blame on the NHS, since under existing law it “controlled” the data and Deep-Mind merely “processed” it. But this difference misses the point that it is processing and collection, not the more possession of bis, that gives the data value.
The great question is who should benefit from the analysis of all the data that our lives now generate. Privacy law builds on the concept of damage to an individual from identifiable knowledge about them. That misses the way the economy works. The data of an individual there gains its value only when it is compared with the data of countless millions more.
The use of privacy law to restrict the tech giants in this instance feels slightly improper. This practice does not address the real worry. It is not enough to say that the algorithms Deep-Mind develops will benefit patients and save lives. What matters is that they will belong to a private monopoly (垄断) which developed then using public resources. If software promises to save lives as drugs now can, big data may be expected to behave as a big medical company has done. We are still at the beginning of this revolution. A long struggle will be needed to avoid a future troublesome. Ms Denham’s report is a welcome start.
1. The agreement between the NHS and Deep-Mind________.| A．put both sides into a dangerous situation |
| B．judged the power of Royal Free hospital |
| C．failed to pay attention to patient’s rights |
| D．caused conflicts among tech giants |
| A．careful assessment | B．sincere apologies |
| C．necessary adjustments | D．empty promises |
| A．All unnecessary date should be inspected. |
| B．The value of data comes from the processing of it. |
| C．It is more valuable to collect user’s data. |
| D．Leaking patient’s data is worse than selling it. |
| A．the violating behavior of big medical companies |
| B．the ineffective enforcement of privacy law |
| C．the centralization of big data by tech giants |
| D．the revolution in the big data industry |
7 . Traditional surgical procedures require surgeons to make large incisions(伤口) in a patient’s body in order to gain access to the internal organs. It was once common for heart surgeons, who perform highly specialized and complex procedures, to make long incisions in a patient’s chest and then split the breastbone to reach the heart. Patients who undergo surgery are often at the risk of infection, as bacteria can infect the cut in the skin. In addition, there is often a lengthy recovery period.
A surgical technique known as “keyhole surgery” has become more common in recent years. In general, the surgeon will make a couple of small incisions around the area where the operation is going to be performed. Tubes are pushed into the holes, and a tiny camera, which is called an endoscope, is put into the body. The camera is attached to a large monitor screen that is positioned so that the doctor can see it while he performs the operation. In addition to the camera, doctors also push their tiny surgical instruments through the tubes. The awkward part of keyhole surgery is that it is counterintuitive; that is to say, if a surgeon wants to move the tool to the left, he or she must push it to the right.
Other advancements in technology are also being used today in the OR (operation room). A new machine called the “da Vinci Surgical System” has been tested in hospitals in the U.S.. Unlike keyhole surgery, the da Vinci’s robot’s moving parts are designed to imitate the natural hand and wrist movement of a surgeon, thus providing better control and sensitivity. The system is controlled by a surgeon from a console(控制台). Sitting at a console a few feet from the patient, the surgeon can perform an operation by holding and moving highly sensitive pads that enable him or her to control the instruments. The area of the body on which the surgeon is working is enlarged on a screen, which is attached to the console. This gives surgeons a realistic three-dimensional view of the area — similar to what they would see during a traditional surgical procedure.
Although the da Vinci Surgical System is undergoing some trials for some procedures, it has been welcomed as revolutionary by many surgeons. Patients with serious illnesses must still undergo major surgery, but the smaller incisions and less invasive procedures typically mean that a shorter recovery time is needed. In some cases, the patient’s stay in the hospital has been cut in half when the da Vinci Surgical System was used. On the downside, some operations have taken up to fifty minutes longer because surgeons are inexperienced at using the new technology. As surgeons become more familiar with the machines, the time needed for surgical procedures is likely to decrease.
1. What can be learned about the traditional surgery according to the passage?| A．The cost of the traditional surgery is very high. |
| B．It often leaves a large wound in a person’s body. |
| C．Long incisions are made in a patient’s chest. |
| D．The incision is often infected after the operation. |
| A．It requires the use of long, thin tools and a tiny camera. |
| B．The doctor can not view the inside of the patient’s body clearly. |
| C．The direction in which a doctor moves the surgical tools is reversed. |
| D．An endoscope has to be inserted into the patient’s body in advance. |
| A．requires that a surgeon make more small incisions on a patient |
| B．reduces the amount of time it takes to perform a surgical procedure |
| C．allows the surgeon to use the surgical instruments more sensitively |
| D．eliminates the need for surgeons to make large incisions on patients |
| A．the challenges brought about by new technology |
| B．the benefits and drawbacks of the da Vinci Surgical System |
| C．the reflections on the development in medical science |
| D．the application of new technologies in modern surgery |
