普通医学英语口语对话.doc

P: Good morning, doctor. D: Good morning, please sit down. What seems to be the matter? P: I think I might have caught a cold. D: How long have you been sick? P: For two days. D: What symptoms do you have? P: I have a runny nose and I ache all over. D: What was the discharge like? P: Watery. D: Is it the same today? P: No, it is yellow and thicker today. D: Do you have a fever? P: I havent taken my temperature yet, but I feel feverish. D: Let me take your temperature. It will take 10 minutes. ... Yes, you do have a fever. Were you exposed to cold temperatures? P: Yes, the day before yesterday when I went to work, the weather was warm so I didnt wear extra clothes. In the evening the temperature dropped down rapidly. On the way home I felt very cold. After arriving home I began to sneeze. When I got out of bed the next morning my nose was stuffy and running. D: Do you have a cough? P: I just started coughing today. D: Do you have phlegm? P: Yes, but not much. D: What color is it? P: Pale yellow. D: Is it easy to cough up? P: Not very. I have to use effort to cough it up. The phlegm is a little sticky. D: Have you been sweating? P: I sweated a little after taking some medicine for fever last night. D: Are you thirsty? P: Yes, I feel like drinking cool water. D: Do you have a sore throat? P: Yes, I do. D: I want to look at your throat. Please open your mouth. D: Do you feel any other discomfort? P: I feel sore everywhere and I feel very tired too. D: Please stick out your tongue and let me have a look. You have a red tongue with thin and yellow coating, which indicates wind and heat in the superficial area. Please put your hand here and let me feel your pulse. ... The pulse is superficial and rapid. P: What does a superficial and rapid pulse mean? D: A superficial pulse means the attack of pathogens to the exterior layer of the body which is called exterior syndrome in Traditional Chinese medicine, while a rapid pulse indicates heat. P: What is the diagnosis of Chinese medicine for me? D: It is a common cold. According to the symptoms, the manifestation of the tongue and pulse, you have got a common wind-heat type cold. P: Can you explain it more in detail? D: Pathogenic wind heat often attacks the body through the nose and mouth. The lung is involved first. Pathogenic wind of yang nature is characterized by upward and outward dispersion. When a fight goes on between the pathogenic wind heat and the body resistance, fever, slight aversion to wind and sweating result. When the pathogenic wind heat attacks the head, symptoms like pain and distending sensation occur in head. P: Thats interesting. D: When the lung fails to disperse and descend, a ten-year-old patient has a cough with yellow, thick sputum. When the pathogenic wind heat stifles the air passage, the patient experiencing a congested sore throat with thirst. Thin, white or yellowish tongue coating, and superficial rapid pulse are the signs showing the lung and the defensive system being attacked by the pathogenic wind heat. P: I see. Id like to be treated with Traditional Chinese medicine. That is why I came here. What kind of treatment will you give to me? D: I suggest the prescription Yin Qiao San for you. It is a typical formula for treating wind heat type of common cold. We may modify it by adding some more herbs to relieve the sore throat and the runny nose. I will give you four doses. Every day take one. Every dose brings to a boil and drain off the liquid. Add cold water and bring it to a boil the second time. Drink the liquid from both times. Do you understand? P: Yes, I do. D: Also, Ill now give you acupuncture treatment on the points of the lung, large intestine and bladder meridians, using the reducing method. This will be very effective in relieving your headache and runny nose. P: Will it be painful? D: No, just like a mosquito bite. After that we may apply cupping to your upper back. ( After the treatment) P: Oh, I feel much better after the acupuncture treatment. My headache has gone and the sore throat has lessened. Thank you. D: After returning home be careful to rest and drink more hot water. This is your prescription. Go to the Chinese medicine pharmacy and fill your prescription. P: Ok. Thank you very much, doctor. D: You are welcome. 参考译文 病人：早上好，医生。 医生：早上好。请坐。您那里不舒服？ 病人：我想我感冒了。 医生：您病了多久了？ 病人：2天。 医生：您有什么症状吗？ 病人：我流鼻涕，而且觉得全身疼痛。 医生：鼻涕怎么样的？ 病人：水样的。 医生：今天也一样吗? 病人：不，今天是黄色的，而且变稠了。 医生：有没有发热啊？ 病人：我没有测过体温，但是我自己觉得发烧了。 医生：让我先帮您测体温。大概需要十分钟。 ... ... 是的，您确实是发热。您怕冷吗？ 病人：是的。前天我去上班的时候天气还挺暖和的，当时我就没有多穿衣服。但晚上温度下降得很快，当我回家的时候我觉得很冷。回家后，我就开始打喷嚏了。第二天早上起床的时候我就觉得鼻塞流涕了。 医生：您有没有咳嗽啊？ 病人：今天刚开始。 医生：您有痰吗？ 病人：有，但不多。 医生：什么颜色的？ 病人：浅黄色的。 医生：容易咯出来吗？ 病人：不是太容易。我需要用力才能咯出。这痰有点粘稠。 医生：您有出汗吗？ 病人：昨晚吃了退烧药后出了一点。 医生：觉得口渴吗？ 病人：是的，我比较想喝冷水。 病人：是的， 医生：我想要看看您的喉咙，请张开口。 医生：您还觉得哪里不舒服吗？ 病人：我觉得全身疼痛，而且觉得非常累。 医生：请伸出舌头让我看看。他的是舌红苔薄黄，提示着风热袭表。 医生：请把手放到这里，我给您把把脉。脉是浮数的。 病人：脉浮数意味着什么？ 医生：浮脉代表着邪袭体表，在中医里这也叫表证，而数脉提示的是有热。 病人：中医诊断是什么？ 医生：根据症状、舌脉的表现，这属于感冒，风热型。 病人：你能详细解释一下吗？ 医生：风热之邪常会通过口鼻侵犯机体，而肺先受之。属于阳的风邪就具有向上、向外升散的特性。当风热之邪与机体正气相互搏斗，就会导致发热、恶风以及汗出。当风热之邪侵袭头部，就会有头痛、头胀等症状的出现。 病人：听起来很有趣。 医生：如肺失宣降，就会出现咳嗽，咯黄稠痰。当风热之邪使气道失于通畅，就会出现咽喉充血，疼痛以及口渴。苔薄白或薄黄，浮数脉都是肺卫被风热之邪侵袭的表现。 病人：我想以中药治疗。这就是我来这的原因。你们将会予我什么治疗呢？ 医生：我建议用银翘散。那是一条典型的用以治疗风热型感冒的方。我们可以在此基础上加一些用于缓解咽痛和流涕症状的草药。我将会给您开四剂药。每天一剂。猛火煎药，然后倒出药汁。然后再加冷水复煎一次。把两次煮的药都喝完，明白吗？ 病人：知道了。 医生：我们能否给他用针灸治疗来缓解症状？我会用泻法在你的肺经、大肠经和膀胱经上的穴位上用针。这对于缓解你头痛和流涕的症状是很有效的。 病人：针灸会很痛吗？ 医生：不会，就像蚊子咬，然后我们可以在他上背部拔火罐。 治疗后 病人：我觉得治疗后舒服多了。我的头不痛了，而且咽痛也缓解很多了，感觉好多了。谢谢。 医生：回家后要注意休息，还要喝多点热水。这是您的处方，您可以到中药店抓药。 病人：好的，谢谢，再见。 D: Good morning, what seems to be the problem today, Mr. Chen? P: Well, Ive had nocturia for six months and I started losing weight four months ago. D: Any other problems? Have you noticed any changes in your urine? P: Yes, its darker, reddish. I wonder if it could be blood. D: Have you noticed anything else? P: Yes. Ive felt sick several times in the morning and Ive noticed my legs are swollen after work in the evening. Also, Ive felt really groggy for some weeks now. I dont seem to enjoy my food any more and Ive lost weight. D: How much? P: About 6Kg. D: How long have you had this trouble? P: About 4 months really. D: Have you ever had trouble with your urine before? P: Yes. Two years ago I had a burning sensation when I passed water. The doctor said that I had high blood pressure as well and he put me on tablets and it cleared up. D: Well, Id like to examine you. Please come to the examination room, remove your clothes except your underpants, and lie on the table. (After examination) D: You can get dressed now ... well, it looks like you have some reduced kidney function. I want you to take some blood tests, X-rays and kidney function tests. Id like you to collect your urine for 24 hours. The nurse will tell you exactly how to do it. Then well ask you to come in for an ultrasound examination of the kidneys. This is a very simple procedure to make sure there is no obstruction. P: Can you tell me exactly what is wrong with my kidneys? D: Well, the tests show that you are in a condition called chronic glomerulonephritis, which has damaged the kidneys. P: Is the chronic glomerulonephritis severe? Are there any good treatments to repair the kidney damage? D: Yes, of course. Youd better stay in the hospital for treatments, and observation. Well have to insert a tube into your abdomen to flash out toxic substances in the blood stream. P: How long will I have to stay in hospital? Will I have to stop working? D: For about 3-4 weeks. Just remind me. Whats your job? P: Im a teacher. D: Well, I should advise you to have a 2-month rest. P: Thank you doctor. D: Not at all. 参考译文 医生：早上好，陈先生，你哪里不舒服？ 病人：我夜尿多（遗尿）六个月了，而且我四个月前体重开始下降。 医生：还有别的不舒服吗？您有没有留意过您小便跟以前有什么不同吗？ 病人：是的，它是暗红色的。我都怀疑那是不是血。 医生：您还发现别的什么吗？ 病人：有啊，我早上和晚上工作后都有几回觉得恶心。我还留意到我的腿肿胀了。我近几周来总觉得头昏眼花，而且也没什么胃口，体重也下降了。 医生：降了多少？ 病人：大约6公斤。 医生：像这样子多久了？ 病人： 大概4个月吧。 医生：您以前小便也有过异常吗？ 病人：是的，两年前我曾在小便的时候有尿道的灼热感。医生检查后也说我有高血压，并给了我一些药片吃，吃了之后就好了。 医生：好的，我想给您检查一下。请您脱下衣服，只剩下内衣，然后躺在那检查床上，先用毛毯盖上，我等下就来。 （检查后） 医生：您现在可以穿好衣服了。我想您的问题在于您的肾没有正常的运作。我希望您能够进行血液、X线以及肾功能方面的检查。同时，我也需要您收集24小时的小便。具体怎样做护士会告诉您。然后，我们会在再让您进行肾的超声检查。然后我们就可以根据这一个非常简单的程序去判断有没有梗阻情况的存在。 病人：您能确切地告诉我我的肾有什么问题吗？ 医生：检验结果显示您得了慢性肾小球肾炎，而那病是您的肾功能受到损害。 病人：那慢性肾小球肾炎严重吗？有针对肾功能损害的好的治疗方法吗？ 医生：呃，有的。我想你需要住院作治疗了，我们将会一直跟踪你的病情。我们要在你的腹部放个管子，通过液体在其中的流通达到清洗血液的作用，同时也把血液中的毒素排出。 病人：那我大概需要住院多长时间？那我是不是需要停止工作呢？ 医生：大概3到4周。您提醒我了，您是从事什么职业的？ 病人：我是一名教师。 医生：那样的话我建议您休息2个月。 病人：谢谢您，医生。 医生：不用客气。 D: Whats the matter with you? P: I have been feeling thirsty recently, and I am always tired. D: How about your urination? P: I pass more urine than I used to. D: How many times a day? P: About eight times. D: How about your appetite? P: My appetite has been good, but I still feel I am losing weight. D: Any other symptoms? P: I cant concentrate on anything for long, and I always feel weak. I have said that, I guess. Sometimes I also feel dizzy. D: How old are you? P: Im 45 this year. D: Sir, do you have anyone in your family who has diabetes? P: Yes, my father has had diabetes for nearly 15 years. What do you mean, doctor? Do you mean I have got diabetes? D: According to your symptoms and your fathers history, there is a strong possibility that you have got diabetes, as the disease runs in families. Of course, we need to do some checks. First please go to the Laboratory Department and examine your urine and blood sugar. Come back to me with the report. (Later with the results of the examination) D: The examination shows an elevation of blood sugar and you have sugar in your urine. You have got diabetes. P: Is it serious? Whats a normal blood sugar level? D: It is <130mg%, Generally it is 80—120mg%. Diabetes is a disease due to the poor function of the pancreas, which brings about metabolic disorder of sugar, fat and protein. Its a chronic disease. At the time being there is still no way to cure it. But as I said your case is not serious now. If you pay attention to treatment your diet and you will get better gradually. P: What else should I pay attention to? Is there a diet for diabetes? D: Having your urine tested regularly to see how your disease is going is very important. On the other hand, you should try to omit sugar from the diet. This includes candy, cake, ice-cream, etc. High starch foods such as bread, potato, rice, etc should be limited, too. P: Thank you very much, doctor. Godbye. D: Goodbye. 参考译文 医生：您哪里不舒服？ 病人：我最近觉得口渴，而且总是觉得很累。 医生：小便怎样？ 病人：小便比以前更多了。 医生：一天几次？ 病人：大概8次。 医生：胃口怎样？ 病人：胃口很好，但我觉得体重反而轻了。 医生：还有别的症状吗？ 病人：我不能长时间集中注意力干活，而且总是觉得疲惫。我想这我刚才都说了，有时我还会头晕。 医生：您多大岁数了？ 病人： 45岁。 医生：那您家里有没有人是得糖尿病的？ 病人：有，我父亲患有糖尿病接近15年了。您这是什么意思啊，是指我患上糖尿病吗？ 医生：根据您的症状和您父亲的病史，也因为这种疾病有家族史，所以您得糖尿病的可能性很大。当然，我们需要做些检查。首先，请到检验科检验一下尿液和血糖。有检查结果后回来找我。 （检验结果出来后） 病人：我的情况如何？ 医生：检验结果显示您血糖升高，尿中也有尿糖。你得了糖尿病。 病人：严重吗？那正常的空腹血糖水平是多少？ 医生：那是<130mg%, 经常是在80—120mg%。糖尿病是由于胰腺功能的失调，引起糖、脂肪和蛋白质的代谢紊乱。那是一种慢性病，具有多尿、多饮、多食的症状。在现阶段还没有方法能治愈。但就像我说的那样，您现在的情况并非很严重。如果您注意治疗和饮食，您会慢慢好起来的。 病人：我还有没有别的什么需要注意的？应该采用什么样的饮食呢？ 医生：定期进行尿液检测以观察疾病的进程是重要的。另外，你必须把饮食中的糖都去掉，这包括糖果、蛋糕、雪糕等，而且也应该限制高淀粉的食物，例如面包、土豆、米饭等。 病人：非常谢谢您，医生。再见。 医生：再见。 D: Good morning! Please have a seat. I just need to get some information from you. Could I have your name please? P: My name is Wang Ping. D: What kind of work do you do? P: I am a taxi driver. D: Thats fine. Now, tell me whats bothering you. P: Well, Ive got a dreadful stomachache and Ive lost my appetite. D: How long have you been feeling this way? P: For about one year. First it was just a slight a pain, but its got much worse recently. D: Could you tell me exactly where the pain is? P: Yes, its right here. This is the worst spot. D: Is it a fixed pain? P: Yes, it doesnt seem to move. D: Does the pain ever spread to any other area? P: No. D: What sort of pain is it? Sharp? Dull? P: Its a distended feeling, and it gets worse if I eat anything cold. D: Do you ever fell it when youre hungry? P: Yes, often, but it gets better if I eat something. D: If you rub or massage it, does it help? P: Yes, it does. D: Do your hands and feet often feel cold? P: Yes, often ... and very cold too. D: Is the pain constant, or does it come and go? P: It comes and goes. D: And how long does each attack last for? P: Oh ... about two hours. D: Do you feel the most painful in the daytime? P: Yes, I think so. Usually about three hours after meals. But sometimes it wakes me up at night. D: Are you aware of anything that brings the stomachache on? P: Its hard to tell. First, I think it comes after I eat raw and cold food. Recently Ive felt it when Im busy at work or Im in a bad mood. D: Generally, hows your appetite? P: Not so good. I always feel bloated. So I dont feel like eating anything. Whats more, no matter what I eat, its tasteless. D: Do you have any burping or acid regurgitation? P: Yes, I burp a lot. D: Have you been very thirsty lately? P: No, Im not interested in drinking anything. D: Do you prefer hot or cold drinks? P: Oh, definitely something hot. D: Have you got any unusual tastes in your mouth? P: Yes, a sour taste, and I get acid regurgitation, too. D: What are your bowel movements like? P: Theyre soft and sometimes I have diarrhea. D: Any problems with passing water? P: No, I dont think so. D: Have you lost any weight lately? P: No, my weight is the same as it was. D: Have you ever had any other problems? P: Id always been in good health and never had any serious problems, not even a cold. D: Do you smoke or drink or have any other habits that might affect your health? P: I dont smoke, but drink a little. D: Have you ever had an X-ray or ultrasound B for this problem? P: Yes, last year I had an X-ray and the doctor said I had a duodenal ulcer. D: Have you ever had any treatment before this? P: Yes, Ive taken lost of tablets, but they havent had much effect. So this time Id like to try some Chinese herbs. D: All right. Now let me look at your tongue, and then take your pulse. Mm ... the tongue is pale and a dull purple color. The coating is thin and white. Your pulse is deep, slow and uneven. According to the theory of Traditional Chinese Medicine, the stomachache youve got is caused by deficient cold affecting the Spleen and Stomach. The treatment principle is to warm the center and dispel the cold. Ill write a prescription for you ... .Here you are. P: Thank you. Ill go and get the prescription filled right away. D: Come to see me again after you have taken the medicine. P: Yes, I will. Goodbye! D: Goodbye. 参考译文 医生：早上好。请坐。我想先了解一些情况。请问您叫什么名字？ 病人：我叫王萍。 医生：您从事什么工作？ 病人：我是一名出租车司机。 医生：哦，那很好。那我有什么可以帮您的？ 病人：我的胃痛的很厉害，胃口都没有了。 医生：像这样子多久了？ 病人：大约一年了。开始的时候只是一点痛，但是最近痛得厉害多了。 医生：能告诉我具体哪里痛吗？ 病人：可以，就是这里。这里是最痛的。 医生：痛处痛定吗？ 病人：是的，它不是游走性的。 医生：疼痛有没有向别处蔓延呢？ 病人：没有。 医生：请告诉我关于胃痛更多的资料。那是什么样的疼痛呢？ 病人：那是一种胀感，而且进食冷食后会加重。 医生：什么东西会加重