011 我的十九世纪医生生涯

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Very early this morning, I was sent to perform a procedure called

bloodletting on a young girl suffering from cholera and I could not do it.

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Perhaps it would be more truthful to say I refused to do it

或许，更诚实的说法是，我拒绝去做。

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I have come to believe that bloodletting, the taking of blood from a patient

is not only without benefit to a person with cholera, but is indeed harmful.

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My name is Mathew Brogan and I am a doctor in the Indian Medical

Service, which serves the British Empire in India.

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The year is 1875 and I am stationed in Calcutta

现在是1875年，我驻扎在加尔各答。

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Before I came to India, I graduated from the medical school at the

University of Edinburgh in Scotland after two years of study.

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My education included physiology, anatomy, surgery, pharmacy, pathology

and the diseases of men, women, and children.

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But nothing I was taught prepared me for the cholera epidemics that

are so prevalent in Europe and Asia these days.

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Hundreds of thousands of people have died from this disease, which causes

abdominal distress and results in the loss of large amounts of body fluids.

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There is no cure for cholera as of yet; many remedies have been tried

but nothing works, least of all bloodletting.

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Yesterday my colleague Doctor McGregor and I were called to a house

where the whole family was sick with the disease.

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The air was filled with the stench of vomit and feces

and the house was full of bodies.

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It was hard to tell who was alive and who was dead

很难分清谁还活着，谁已经死了。

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According to the neighbors, the family had just returned from a pilgrimage

to the Temple of Jagannatha in the town of Puri.

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This fact reminded me that large gatherings of people tend to trigger

cholera outbreaks, but the reason why is unclear.

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We walked past an older man lying on a cot outside the front door

我们走过一个躺在前门外小床上的老人。

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It was obvious that nothing could be done for him; his eyes were

deep in their sockets and his skin was blue.

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The sick man resembled a raisin — a dried fruit

that has lost all its moisture.

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I kneeled next to two children inside the house who were

also near death and examined them.

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A woman, probably their mother, was nearby; she was

vomiting and had severe diarrhea.

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McGregor instructed me to bleed her, so I used my

spring lancet, a very efficient tool.

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But I had a difficult time piercing her shriveled skin

可我很难刺穿她干瘪的皮肤。

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The blood, when it finally emerged, was dark, thick, and gummy

终于流出来的血又黑又稠，黏糊糊的。

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How could such thick blood flow through the heart?

这么浓的血，怎能在心脏里流动呢？

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The woman died within the hour, and I could only ask myself, why did we

try to take more fluid from a body that was already dry?

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As I walked home with Dr. McGregor, I was troubled and said to him

和麦格雷戈医生走回家时，我心里很乱，对他说：

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" At Edinburgh, my professor, Dr. Joseph Lister, spoke of a theory

proposing that a bacterium, an invisible organism, causes cholera.

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Another prominent doctor supports that claim too and believes

the germ is carried by dirty drinking water."

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McGregor stopped and faced me. He pushed his finger into my chest

麦格雷戈医生停下脚步，转身面对我，用手指戳着我的胸口。

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" I've heard of those tiny germs, and I don't believe in them," he said

“我听说过那些小病菌，我可不信，”他说。

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" Nobody believes in them! It's just bad air, Brogan

“没人信那些理论！就是空气不好，布罗根。

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Besides cholera usually affects only the ignorant and the poor."

再说，霍乱通常只影响无知的人和穷人。”

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I wondered to myself how air breathed by the poor would be

different than air breathed by the wealthy.

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It is true that the poor get the disease more than the rich

穷人确实比富人更容易得这种病，

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but the reason for that could be the conditions in which they

live—the crowding, the lack of sanitation.

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Lister's germs thrive in filth, so perhaps the cholera germ

whatever it is, thrives in filth as well.

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" That woman had no fluids left," I said to McGregor

“那个女人的体液都耗尽了。”我对麦格雷戈说。

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" Her blood barely flowed. Perhaps we should not have taken her blood."

“她的血几乎不流了。也许我们不该给她放血。”

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But McGregor insisted that he had been treating cholera since 1853, and

that bloodletting was an appropriate treatment for the disease.

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Despite McGregor's opinion, when I was called to that young girl's side

this morning, I decided to try something different.

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Her face looked haggard, and she complained of stomach

cramps and occasional diarrhea.

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When I informed her it was the first stages of cholera

she seemed resigned to her death.

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We often use a mustard plaster to treat cholera because it is believed

that the plaster eases a patient's pain and cramping.

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A mustard plaster is made with a paste of dry mustard, a bit of flour, and an

egg, which is then spread on a cloth and placed on the abdomen or back.

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Once placed on the patient's skin, the mustard plaster becomes

hot and draws the body's blood to that area.

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But this time I decided against that remedy and settled on opium, a medicine

I know to be effective in relieving diarrhea and cramps.

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I also offered her sips of cool ginger tea that I brought with me

我还让她小口喝我带去的凉姜茶。

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Just in case the new theories are right and the disease is indeed carried

in contaminated water, I asked her mother to boil any water they drink.

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I checked on her at noon, in between seeing other patients

中午在看其他病人的间隙，我去看了她。

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Even though she had started vomiting, she was not becoming

shriveled like so many other victims.

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I instructed her mother to keep wet compresses on her

forehead (using clean, cooled water only)

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and to continue giving her daughter as many sips

of ginger tea as she would tolerate.

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" She needs to replace the fluids she's lost," I admonished

“她需要补充失去的体液。”我叮嘱道。

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In the evening I checked on my patient again

傍晚我又去看望了我的病人。

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She was feverish, and although her mother was concerned, I was gratified

她在发烧，虽然她母亲很担心，我却感到欣慰。

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Fever is a symptom that tells the doctor the body is fighting

back against an infectious disease.

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After convincing them both that she would recover, I headed home

说服她们母女她一定会康复后，我就回家了。

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One patient is not sufficient proof, but I am

glad I did not bleed this patient.

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I will continue to experiment with other kinds of treatments, and

someday I hope to understand what causes cholera.

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These are exciting times to be a doctor, and I look forward to

finding a cure for this devastating disease.