Postmortem with Strings英语泛读翻译

Postmortem with Strings 英语 关于好奇心的名言警句英语高中英语词汇下载高中英语词汇 下载英语衡水体下载小学英语关于形容词和副词的题 泛读翻译 Postmortem with Strings What eventually led to the premature death of Mozart? Centuries after his demise, an unusual clinical pathology conference was held in Maryland to diagnose the genius' death, at which Professor Faith Fitzgerald presented her peculiar diagnosis. How unusual was the conference? How did Professor Fitzgerald conduct the postmortem? The following article will get these puzzles clear. Down on the brick floor of the University of Maryland's Davidge Hall, a noted professor of medicine is about to perform a most unusual postmortem. Although this domed amphitheater with its steeply rising seats has hosted medical lectures and demonstrations for more than 200 years, today's offering is exceptional, for the deceased's remains are nowhere in sight. And at the conclusion of the autopsy1, a string quarter will present a program of 18th-century music. The occasion is the university's sixth annual historical clinical pathology2 conference. Each year the university's medical school invites a physician to diagnose the mysterious maladies of historical figures ranging from Edgar Allan Poe to Alexander the Great. This year's patient is a 35-year-old male who died in Vienna after a two-week illness. His body was consigned to a common grave, but his genius still resounds in concert halls the world over. “We are disquieted when extraordinary people die of ordinary things,” begins Faith Fitzgerald, an internist and professor of medicine at the University of California, Davis School of Medicine. Her introduction sounds a cautionary note for those who would haste to interpret the synopsis that follows. At the height of his creative powers, and while enjoying a spell of good health, the subject fell suddenly and ferociously ill, succumbing to high fever, headaches, profuse sweating, and swelling of his hands and feet. Within a few days the swelling of his hand spread to his whole body , a condition known as anasarca. The bedridden victim also developed a rash on his chest and belly; after a week of illness, he complained of generalized aches and pains and endured bouts of vomiting and diarrhea. He remained conscious and alert until the night of December 4, 1791, when he became delirious, lapsed into a coma, and died just after midnight. Controversy has surrounded this particular case history, Fitzgerald explains, because of the deceased's celebrity status: Wolfgang Amadeus Mozart's death “wouldn't have been mysterious at all if Wolfgang Amadeus Muller had died that December night.” Strastruck physicians have since ascribed Mozart's death to more than 100 causes. “Each of these [diagnoses] is argued with a passion disproportionate to the data,” Fitzgerald points out. “And of course, Mozart died of syphilis3 as well as everything else, because every great man dies of syphilis.” The physicians who attended the sickly composer weren't much help, either. Their succor amounted to a blood-letting and a few cold compresses. No autopsy was performed on the body. According to musicologist Neal Zaslaw of Cornell University, who sketches a brief Mozart biography, the death and burial entries in two church registers list the cause of death as “severe miliary fever,” a generic descriptor at the time for any syndrome marked by a seedlike rash. Press reports of his passing supplied such colorful and sinister diagnosis as poisoning, venereal disease, and dropsy of the heart, the 18th-century term for fluid retention and severe swelling. Even some learned men who examined Mozart as a child had formulated their own opinions about his eventual demise. “They believed that each individual is born with a finite store of vital essence and when that essence was consumed with the intensity they perceived in the young Mozart,” says Zaslaw, “it was likely to be exhausted prematurely, it leads to an early death.” Thus, overweight imaginations and the sands of time have turned tragedy into a medical mystery aching to be solved. That's just the sort of material that appeals to the school's vice chair of medicine, Philip Mackowiak, who launched the conference six years ago after reading an account in a Maryland historical magazine of Edgar Allan Poe's final days. He hired an actor to play Poe and asked his colleague Michael Benitez to review the writer's medical history. The diagnosis , death by rabies4 , was topped off, appropriately enough, with a monologue from Poe's story “The Black Cat.” The rabies theory attracted enough attention to become a question on the TV game show Jeopardy. Since then, conferees have taken on Alexander the Great, Beethoven, and the Athenian military and political leader Pericles. So far, the diagnoses made by Mackowiak's medics tend to be familiar, if not mundane , and that's part of what makes the conference not just interesting but useful to the doctors-in-training who attend. There's a thoroughness to the historical diagnostic procedure that is sometimes lost in contemporary clinical practice, says Paul Sehdev, an M.D. in his final year of training in infectious diseases. “Once you get past your internship and residency, you tend to make automatic diagnoses, without going through all the possibilities,” he says. It's instructive, too, to watch another physician work through a case without the benefit of modern technology, says Sehdev. In Mozart's example, the most compelling symptom , anasarca , has three common causes: liver disease, kidney disease, and congestive heart failure. Lacking modern lab techniques, Fitzgerald must use deductive reasoning. Her first step is to discount liver disease because there was no evidence of jaundice5. Some medical historians have implicated kidney disease because of Mozart's malformed ear. Ears and kidneys develop at about the same time in the human embryo; hence, a malformed ear may indicate problems with the kidneys as well. But Mozart had no history of renal dysfunction6, Fitzgerald says. And advanced kidney disease produces delirium earlier in the course of illness. So Fitzgerald settles at last on congestive heart failure, which can cause anasarca if the heart can't pump enough blood through the kidneys to eliminate fluid-retaining salts. Heart troubles would be easy to confirm with any one of the stethoscopes that adorn audience members at Davidge Hall. “Unfortunately,” says Fitzgerald, “Mozart died more than a quarter of a century before the invention of stethoscopy. And there was no description of his doctor's leaning an ear against his heart to listen to it. If I were facing a really swollen, febrile, rashy, sweaty guy, I might not want to put my ear on his chest either.” Fitzgerald notes, however, that at the time of Mozart's death an epidemic of rheumatic fever is said to have besieged Vienna. Rheumatic fever is triggered by an invading bacterium that elicits antibodies from the immune system. The antibodies attack the bacterium, but they can also attack tissue in a vulnerable host's own heart, skin, joints, and brain. This reaction can cause congestive heart failure, Fitzgerald points out, as well as the rest of Mozart's physical symptoms. And chorea, the neurological consequence of rheumatic fever, could account for Mozart's final delirium, as well as the puzzling change of character that prompted him to drive his pet canary out of the sickroom days before his passing. “One could say that the epidemic was immaterial to his death, that it was coincidental,” she says. “But I think it's bit of arrogance to dismiss it.” Applying the principle of Occam's razor , which states that the simplest explanation for a phenomenon is the most probable , Fitzgerald formalizes her diagnosis: congestive heart failure brought on by rheumatic fever. The audience seems calm and deeply satisfied, as if absorbing a eulogy for a departed friend. Sandwiches are passed around, the string quartet warms up, and as the first note is struck, Wolfgang Amadeus Mozart lives again. 是什么最终导致了莫扎特的早逝,他死了数百年后，在马里兰州召开了一次不同寻常的临床病理学会议，以诊断这位天才的死因，会上，费思? 菲茨杰拉德教授提出了其独到的诊断意见。这次会议如何不同寻常,菲茨杰拉德教授又是如何进行尸检的,下面的文章将会澄清这些疑团。 在马里兰州立大学戴威基大厅里的砖铺地面上，一位著名的医学教授正准备进行一次最为不同寻常的尸检。虽然两百多年来，这座前后座椅间坡度很大的带圆顶的圆形剧场举办了各种医学讲座及演示，今天提供的 内容 财务内部控制制度的内容财务内部控制制度的内容人员招聘与配置的内容项目成本控制的内容消防安全演练内容 却不同一般，因为根本见不到死者的遗体。尸解结束时，一个弦乐四重奏乐队将奉献十八世纪的音乐节目。这儿正在举行的是该校第六次历史临床病理学年会。每年，该大学的医学院会邀请一位医生就一些历史人物——从艾德加?爱伦?坡到亚历山大大帝——所患的神秘疾病作出诊断。今年的病人是一位三十五岁的男性，患病两周后死于维也纳。他的遗体被安葬在一个普通的墓地里，但他那才华横溢的音乐至今仍在世界各地的音乐厅中回荡。 费思?菲茨杰拉德是内科医生，加利福尼亚大学戴维斯医学院教授。她首先提出:“当一些杰出人物死于普通疾病时，我们就会感到不安。”她的开场白给那些急于解释随后的研究的人提了个醒。当事人当时正处于创作的颠峰期，且那一阵健康状况很好，突然一病不起，发高烧、头疼、盗汗、手脚浮肿。几天之内，浮肿就扩散到了身体各处——也就是我们所说的全身性水肿。这位受害者卧病在床，胸部和腹部还出了疹子。病了一周时间之后，他诉说全身疼痛，遭受了阵阵呕吐和痢疾的折磨。他神智仍一直清醒和警觉，但到1791年12月4日晚，出现谵妄症状，陷入昏迷，午夜过后便病逝。 费思?菲茨杰拉德解释说，围绕着这一特殊病历的争议，是因为死者名人身份:沃尔夫冈?阿马戴乌斯?莫扎特的去世“一点儿都不会神秘至今，如果那个十二月的晚上死去的是沃尔夫冈?阿马戴乌斯?穆勒的话。”此后，被名人效应左右的医生们归结了一百多种使莫扎特死亡的病因。菲茨杰拉德指出，“这些[诊断]的每一种，争论时的热情要远大于对数据的关注。”“当然，莫扎特死于梅毒，死因怎么说都行——因为每个伟人都死于梅毒。” 曾给生病的作曲家看病的医生们同样也帮不上什么忙。他们的救助方法就是放血或用冷敷布降温。当时没有对尸体进行尸检。康奈尔大学音乐理论家尼尔?扎斯罗简述了莫扎特生平，据他所说，莫扎特死亡与安葬时，两座教堂载明的死因都是“严重的粟疹热”，在当时这是对出现籽状疹症候群的一种通用描述。报纸上登载的关于其死亡的诊断则有声有色，不怀好意，认为是一种有毒的性病，还有心脏浮肿——这在十八世纪用来指体液潴留及严重水肿。 甚至一些在莫扎特小时侯给他检查过身体、颇有学识的人士，对他最终的死因也形成自己的看法。扎斯罗说，“他们认为，每个个体生来就存储有限的生命要素，当这种生命要素以他们认为的在年轻的莫扎特体内的强度消耗时，这种要素就可能提前耗尽，导致早逝。” 就这样，过多的想象以及时间的流逝，使悲剧演变成一个亟待解决的医学之谜。对于该医学院副院长菲利普?迈考威艾克来说，这正是他所感兴趣的材料。六年前，他在一本马里兰州的历史杂志上读到一篇关于艾德加?爱伦?坡临终情况的叙述，然后便发起组织了这个会议。他雇了一个演员扮演坡，还邀请他的同事迈克尔?本尼特斯重新审查这位作家的病史。 用选自坡所著的故事《黑猫》中的一段独白，恰如其分地最终得出诊断结果:死于狂犬病。死于狂犬病的说法吸引了相当多的注意力，以致成为电视益智问答节目《危险》中的一个问题。 从那以后，参加会议的人探讨过亚历山大大帝、贝多芬以及雅典军事和政治领袖培里克利斯 的死因。到目前为止，迈考威艾克的医学同行们所作出的诊断 ，要是不算平庸的话 ，也是比较常见的——这使得会议不仅有趣，而且对于与会的受训医生来说也很实用。医学博士保罗?萨赫戴夫正在传染病研究领域接受最后一年 培训 焊锡培训资料ppt免费下载焊接培训教程 ppt 下载特设培训下载班长管理培训下载培训时间表下载 ，他说，给历史人物会诊过程中体现一种 彻底性，而当前临床实践有时就缺乏这一点。“一旦你过了见习期及住院实习期，你就容易不假思索地作出一些诊断，而不仔细考虑所有的可能性。” 萨赫戴夫说，通过没有现代科技帮助的一个病例考察另一种医疗工作，也具有启发性。在莫扎特这个例子中，最显著的病症——全身水肿一般有三个成因:肝脏疾病、肾脏疾病以及充血性心力衰竭。没有现代的实验技术，菲茨杰拉德必须运用演绎推理。她第一步是排除肝脏疾病，因为并没有出现黄疸症状。 一些医学史家曾暗示是肾脏疾病，因为莫扎特的耳朵有些畸形。耳朵和肾脏几乎在人类胚胎阶段同时发育;因此，畸形的耳朵也可以表明肾脏有问题。但是菲茨杰拉德说，莫扎特并没有肾脏机能不良的病史。而且，严重的肾脏病在发病过程中产生谵妄症状时间要早。 因此，最后菲茨杰拉德转向了充血性心力衰竭。如果心脏不能泵压足够的血液通过肾脏以排出存在于体液中的盐分，也可能会导致全身水肿。用戴威基大厅配备的听诊器，在场的任何一位听众都会很容易确诊心脏疾病。“不幸的是，”菲茨杰拉德说，“在莫扎特死后二十五六年 才发明听诊检查。而且也没有记录表明，他的医生曾经把耳朵贴在胸部听心跳。如果我真得面对一个出疹、发烧、盗汗、浮肿的家伙，我大概也不会想要把耳朵靠在他的胸部。” 但是，菲茨杰拉德注意到，据说在莫扎特去世时，维也纳正遭受一场流行性风湿热的侵扰。风湿热的形成是由于某种细菌入侵诱发免疫系统产生抗体。抗体袭击细菌，但它们也可能会袭击体质虚弱的寄主的心脏、皮肤、关节和大脑。菲茨杰拉德指出，这种反会引发产生在莫扎特身上的其它病症，也会导致充血性心力衰竭。风湿热对神经系统造成的后果舞蹈病，可以用来解释莫扎特临终时的谵妄症状，也可以解释其令人困惑的性格变化——在去世前几天， 这种变化导致他把自己最宠爱的金丝雀从病房中赶了出去。 她说:“人们可以说那场流行病对他的死因并不重要，那只是巧合而已。但我认为，要是对此不加以考虑，则有些自大。”菲茨杰拉德运用奥卡姆剃刀原则——即对某一现象最简单的解释可能性最大——作出了诊断:由风湿热引起的充血性心力衰竭。 听众们显得平静，而且深感满意，就好象沉浸在对一位亡友的颂扬之中。人们分发着三明治，弦乐四重奏乐队正在做演出准备，当第一个音符奏响的时候，沃尔夫冈?阿马戴乌斯?莫扎特又重获生命。