一、主要调查项目：
1.主诉chief complaint：weakness, malaise, chills, fever, sleep, pain, headache, appetite, weight, stomach and bowels, nausea and vomiting, diarrhea, urine, genitalia, neuropsychiatric disorders, respiration, shortness of breath, bleeding or discharge, etc.
2.现症历present illness：onset(date, mode), duration before present entry, exciting cause and environmental influences, prodromal symptoms, general symptoms, course or progress( location, duration, severity, continuity, intermission, radiation, treatment), aggravating and alleviating factors, loss of weight, appetite and strength, sleep, bowel movement, frequency of urination, menstruation, etc.
3.既往历past history：
1)former places of residence, previous stage of health( 健壮的robust，纤弱的delicate), experience with similar disease, immunity to infectious disease
2)previous illness：麻疹measles, 腮腺炎mumps, 水痘chicken-pox, 百日咳pertussis, 流行性感冒influenza, 猩红热scarlet fever, 白喉diphtheria，伤寒typhoid fever, 支气管炎bronchitis, 肺炎pneumonia，脑炎encephalitis,脑膜炎meningitis，破伤风tetanus,小儿麻痹poliomyelitis,赤痢dysentery，霍乱cholera, 胸膜炎pleurisy,天花small-pox，疟疾malaria,结核病tuberculosis，黄疸病jaundice，过敏性反应allergy,etc
3)venereal disease：specific symptoms, signs, and the disease by name, treatment.
4)Accidents( date, any disability, sequelae), operation and hospitalization (date , procedure, name of hospital , physician, complications, bleeding tendency)
4.家族历family history：family tendency, presence of hereditary disorders, cancer, tuberculosis, mental disorder and nervous affection, rheumatism, diabetes, hypertension, cerebral vascular accident, hemophilia, syphilis, tumor, epilespsy, allergy, contact with diseased individuals, relationship of patient’s childhood and adult life, age, health condition, and cause of death of parents, grandparents, self , spouse, siblings , or relatives. 5.个人历personal history：
1)Social history：fears, metal status, education, financial condition, number of dependents, family harmony or fractious , hygienic condition at home 2)Marital history：duration of marriage, 1st or 2nd marriage, age and death of spouse and children , cause and age at time of death, number of children , pregnancies, 流产次数miscarriages, 死产数 stillbirths
3)occupational history：duration of employment, past work, exact nature of work, exposure to occupational hazards, whether work is satisfactory or not.
4)Habits：alcohol, tobacco, narcotic, coffee, tea, appetite, food habits, regularity of meals, rapidity of eating , bowel movements, sleep, exercise, interests, etc. 6.系统检查system review：
1)General：nutrition, fever, night sweats, tremor, weight gain or loss, weakness, allergy. 2)Skin：荨麻疹hives, rash, eczema 3)Head：trauma, headache, loss of hair 4)Eyes：vision, pain glasses diplopia.
5)Ears：pain, discharge, deafness, tinnitus.
6)Nose：obstruction, discharge, epistaxis, rhinitis.
7)Mouth：teeth, lips, gums, tongue, disturbance in taste.
8)Throat.：sore throat, tonsillitis, 脓性扁桃腺炎quinsy, dysphagia 9)Neck：adenitis, goiter , rigidity
10)Cardiorespiratory：palpitation, tachycardia, blood pressure, chest pain, dyspnea, cough , hemoptysis , seasonal cold, expectoration.
11)Gastrointestinal：appetite, nausea, vomiting, distress(before or after meals), melena, colic, jaundice, fullness, hernia, hemorrhoid, constipation, diarrhea, frequency of bowel movement , heartburn, idiosyncrasies, relation of symptoms to eating, type and quantity of food
12)Genito-urinary：dysuria, urinary frequency, dribbling , hematuria, pyuria, nocturia and volume, enuresis, incontinence, sores about external genitalia, symptoms suggestive of syphilis(mucous patches, falling hair), urethral discharge, exposure to venereal infection, obstetric history, catamenia(age of onset, date of last period, cycle and amount, periodicity , dysmenorrheal, menopause) leucorrhea, associated headache
13)Neuromuscular：神经过敏nervousness, emotional stress, weakness, muscle or joint pains, convulsion, numbness, neuralgia, anesthesia, muscular atrophies or dysatrophies, deformities. 二、病历与时态
1．现症历(present illness)：
1)A.现在式：表示一般的真理、职业、人格、习惯和现在的事实、动作或状态。 例1：Sedentary habits often interfere with health
例2：He is mentally deranged and disoriented as to time, place, and person 例3：He gets up at 6 every morning.
B.现在进行式（Be+ pres. p.）表示现在某动作正在进行中。 例1：Both his parents are still living and well. 例2：The patients is getting worse and worse. 例3：The patients is progressively doing well.
C.表「经常的习惯」也用进行式，通常与always, constantly等副词连用。 例1：He is always taking a nap in class.
例2：He is constantly forgetting peoples’ names. 例3：He is for ever complaining of headaches. D.通常不用进行式的动词。
a)不随意动词( Verbs of involuntary actions)：
-知觉( perception)：feel, hear, notice, see, smell等。
例1：Whenever he has a cold, he can neither taste nor smell.
-知识(knowledge)：believe, (dis)agree, doubt, find, forget, know, mind, remember, think, understand等。
例1：She does not remember specific scratches which might have preceded the present lesions. -感情( emotion)：desire, despise, disgust, fear, hate, hope, (dis)like, love, prefer, want等。 例1：He likes lobster, but it disagrees with him.
b)表示继续状态的动词( Verbs of continuous state)：表示存在、所有等动
词：appear, be, belong, consist, flow, have, hold, live, look, possess, resemble, seem等。 例1：Her fingers and hands are stiff and cyanotic. 例2：He has no discomfort and eats well. 2)A.现在完成式( Have+ p.p)
a)表示动作的完了(completion of an action)或其结果的现在状态(present state of things)：
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例1：The patient has passed the crisis. = The patient is out of danger now. 例2：He has caught cold. = He has a cold now.
注：常用的连用副词为：all this while, (not) yet, already , just, now, by this time, today, this week( or month, year, etc.), hitherto, till now, up to( till) now, recently, lately, of late等。 比较：过去式仅表示过去的动作状态；现在完成式则以表示现在为主。 例1：He had no appetite for food. (过去式)→表示过去某时有过食欲不振
例2：Lately he had had no appetite for food. (现在完成式)→表示现在仍然胃口不佳。 b)表示截至现在为止的经验( experience)：
例1：He has seldom consulted a doctor in his life.
例2：He has never been treated by a doctor since he was born. 注：表示经验时，常用的副词为：ever, before, once, many times, (very) often, seldom, sometimes, in one’s time等副词。比较：同一动词有时表示完了，有时表示经验，视其所连用的副词而决定。
例1：He has just undergone a nephrectomy.→表示动作完了。 例2：He has undergone a nephrectomy once.→表示经验。 c)表示截至现在为止的动作或状态的继续（continuance）
例1：He has been deaf in the left ear since the age of 18 and has experienced slight dizziness on stooping.
例2：Except fro a slight loss of energy, he has always felt well. 例3：For the past 10 years he has had persistent and high-pitched tinnitus in his left ear, consisting a buzzing sensation and, occasionally, the sounds of bells.
注：常用的连用副词为：since, always, from, for, these, how long？ B.现在完成进行式( Have been +~ing)
a)表示以前开始的动作继续到现在的状态：
例1：He came here 2 weeks ago, and has been lying sick with a cold since then.
例2：The patient has recently had experience of memory loss and of spells of dizziness. For the preceding 5 years she has been receiving treatment for hypertension. b)表示「习惯」：
例1：The patient has been smoking excessively.
例2：She has been chewing a wad of bubble gum all day.
注：常用的连用副词为：since, for, how long？,these, form, always等。 比较：
例1：He has been learning medicine for 5 years. (继续) 例2：He has learned medicine for 5 years. (经验)
2．既往历(past history)：大半用过去式，但发生过去某一定时间以前者，宜用过去完成式；如果疾病发生的前后关系甚明显，或以年代顺序记载时，仍可用过去式。 1)A.过去式：用以表示过去的动作、状态、习惯等且与现在的情形毫无关联。 a)发生于过去某时者：
例1：An unknown number of years ago he was said to have pneumonia.
例2：In addition to the above symptoms, he noted some vague abdominal pain for a couple of months in the past.
例3：At that time she had a slight nonproductive cough and mild exertional dyspnea. 例4：Before therapy, she was unable to swallow anything but small sips of water. b)过去某时以后的状态：
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例1：In the previous month she noticed that the stools were greatly flattened. Subsequently she became aware of a bearing-down pain the rectum.
例2：Menarche occurred at age 13, thereafter menses were regular, every 28 days, lasting 3 to 4 days each time.
例3：The patient had tinnitus in his left ear 10 years before being discharged for the military service. Several year later, he noted loss of hearing on the left.
例4：In June 1956, a sterilizing operation was performed at a hospital. For the ensuing 5 months the patient was troubled with intermittent attacks of vague abdominal pain. 例5：Two years after this episode she had one short attack of vertigo but has been attack-free for 2 years.
注1：过去式常用的连用副词：ago, last night, yesterday, the day before yesterday, the other day, this morning , just now等。
注2：现在完成和过去两者都可用的连用副词：just, ever, lately, recently,
once, always, already, this morning, today, every night, this week, these few days, for the last few days, since last week, before, yet等。
B.表示过去的习惯时，须用used to , was (were) accustomed to ~或had the habit to ~等。用would来表示过去的习惯时，大抵与often, sometimes等副词连用。 例1：He used to work far into the night.
例2：He would sometimes come home drunk, and beat his wife.
C.过去进行式( Be 动词的过去式+ pres. p.)：表示在过去某一时间正在进行 的动作： 例1：One sister was suffering from active tuberculosis.
例2：He was having mild symptoms of fever and nausea at the time he was seen. 例3：He was raising large amounts of purulent sputum at that time.
D.过去完成式( Had + p.p.)：表示截至过去某一时间为止的动作的完了、经验、继续等。 a)完了( completion)：
例1：The patient had already expired when he came. 例2：By that time he had immunized against smallpox. 连用副词：already, by that time, (not) yet, only just等。 b)经验(experience)：
例1：Till then he had never seen so-called bone-setter. 例2：He could not repeat what he had said before. c)继续(continuance)：
例1：He had long been ill in bed.
例2：He had been ill in bed for a long time.
E.过去完成进行式(Had been + pres. p.)：表示继续过去某一时间的动作。 例1：Up to that time, he had been drinking mush wine.
例2：Due to her increasing constipation, she had been taking laxatives daily for one year before admission. 比较：
例1：I was sleeping when he came. (过去进行式)
例2：I had been sleeping for an hour before he came.(过去完成进行式) 三、家族历 1.家族无~病：
例1：There is no family history of anemia or other relevant disorders.
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例2：The family history did not reveal the occurrence of any congenital anormaly. 2.家族历无异状：
例1：Family history was allegedly not remarkable.
例2：His family history was irrelevant to the present illness.
例3：Her family history , besides the fact that her brother died form Darier’s disease, was no contributory.
例4：There is nothing important in his direct or collateral hereditary antecedents. 3.健康：be in good health；be healthy 不健康：have a bad health；be unhealthy
例1：His farther is well with no evidence of illness. 例2：His grandfather 87, is still hale and healthy. 4.家族有~病：
例1：He is the only member of a family of 5 have Hodgkin’s disease.
例2：Family history showed chronic gastrointestinal symptoms in a maternal cousin. 5.家族有~倾向：
例1：There was a strong family history of hemophilia；6 members of the present generation were affected.
例2：There was a high incidence of gallbladder disease in the family. 6.过敏：
例1：He had no history of penicillin sensibility, however, he once noted petechiae after taking aspirin.
例2：No asthma, hives or any idiosyncrasy to foods. 7.因~而死：
例1：His father’s death was coincidental with the patient’s illness.
例2：His eldest brother died of pneumonia at the age of 28 in the preantiboitic era. 四、个人历 1.吸烟：
例1：History revealed that he started smoking 10 years before, at the age of 23, and has smoked ever since. At first he smoked only a few cigarettes a day but gradually increased this to three-fourths of a package per day, his present rate.
例2：He now smokes an average of 2 packages of cigarettes daily and has averaged this amount for the past 7 years. 2.饮酒：
例1：The patient admitted to excessive use of alcohol for years with a grossly inadequate dies. 例2：He customarily consumed up to 2 bottles of beer a day on weekends but denied long period of alcoholic excess or the daily use of alcohol. 3.饮食：
例1：The boy never ate any fresh fruits or vegetables and did not like milk.
例2：She took supplemental multivitamins daily and used a variety of mouthwashes. 4.工作：
例1：The patient’s occupation ( for more than five years) necessitated his breathing acid fumes. 例2：His complaints persisted, and he was unable to resume his regular work. 5.分娩：
例1：The history relative to her pregnancy suggested that she was in her 5th month of gestation
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( pregnancy).
例2：She is a 30-year-old primigravida with long-standing sterility (infertility). 6.其它(卫生、习惯等)： 例1：He spent 3 months visiting Taipei in early 1960 and denied travel outside of Taiwan after that time.
例2：The pt. related that she has always lived in Peitou expect for 8 months during 1958~1959 when she temporarily moved to Tienmoo.
例3：The house was located in a river valley and , therefore, was in a damp, foggy area. 例4：The families of both parents were long residents in the same rural area in Taitung prefecture. 例5：He was born in a small village of illiterate and primitive parents.
例6：The family had a sick kitten and also kept dogs at the time of the present illness. 例7：He preferred the supine position partially rotated to the right side. 例8：The patient stated that he was in the habit of spending a great deal of time at the beach during the summer.
例9：She lacked outside interests and was apathetic.
例10：His interests and activities centered mainly on his job. 例11：The patient is not in a good term with his boss.
例12：His income was somewhat above the average for the area in which he lived, and he was well satisfied with his present occupation. 五、既往历Past History
(1)他一直很健康，到1960年10月，才慢慢地开始有咳嗽和脓痰。
He had enjoyed good health until Oct. 1960, when he gradually developed cough and purulent sputum.
※到某时一直健康
-几乎未生病 be barely ever sick
ex1：He had been well until Nov. 1960, at which time he was found to have diabetes mellitus. ex2：He was apparently healthy most of his life, and did not consult a physician until his present illness.
(2)以前他没有患过任何病，在幼小时所做的一般免疫，并无不良反应。
He had no illnessnes of any kind before and received routine immunizations at an early age without ill effects. ※未曾患过病
ex1：He denied experiencing episode of coughing at any time in his life.
ex2：He denied any history of prior cardiovascular symptoms before onset of the present illness. (3)他曾患过通常的小儿期疾病和肺炎一次，这些病都顺利痊愈。
He had the usual childhood diseases plus one bout of pneumonia from which he made uneventful recoveries. ※生过病
-患病 suffer from；have an attack of ；be attacked by
-在童年时代患过麻疹，但无合并症发生 have measles during childhood without complications -一起身就会头晕 experience light-headed on sitting up
-患严重的喘息性支气管炎 contract severe asthmatic bronchitis ex1：He had a lunatic tendency 4 years ago.
ex2：He has been a known diabetic since 24 years of age.
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※除~病外未患过病
ex1：His early development was normal and he suffered no significant illness apart from measles at the age of 5.
ex2：Except for childhood disease he has had no more serious diseases untilnow. ※免疫
ex1：He was vaccinated in childhood, and reacted in a routine manner.
ex2：The first D.P.T. immunization was given at 3 months, and was followed by high fever, lethargy. ※易患~
-常常感冒 be subject to frequent colds -容易感冒 be apt to catch cold -多病 prone to illness
ex1：Although he was subject to joint pains in his childhood, he gave no definite history of rheumatic fever.
ex2：She was susceptible to car sickness, a tendency which had been less pronounced in the past year.
(4)他有在22岁患过肺炎的病历。
He has a history of pneumonia diagnosed at the age of 22. ※诊断\\
-诊断 diagnose (the case as) ；establish (make) a diagnosis -误诊 make a wrong diagnosis；misdiagnosis
ex1：He has a history of being diagnosed as pneumonia 4 years ago. ex2：He states that a diagnosis of pneumonia was made 4 years ago. ※「诊断」记载例
ex1：Diagnosis：senile paranoid
ex2：Diarrhea and vomiting of undertermined etiology. ex3：Malignant gastric ulcer, as much as could be observed. ※诊断书\\
ex1：This certifies that the above named patient suffered from the disease stated above.
ex2：This is to certify that the said patient is seriously sick with liver atrophy. It is recommended that he should be confined to hospital for good care and treatment for a period of one month.
(5)他于1952年10月16日，因肺结核接受部分胸廓成形术，而住了院。 He was admitted on Oct. 16, 1952 to undergo a partial thoracoplasty for pulmonary tuberculosis. ※年月日
-在8月3日黄昏 on the evening of Aug. 3 -去年11月 in Nov. last；last Nov.
-在前几个月当中 during the past couple of months
-在上月初(月中、月底) at the beginning (middle, end) of last month -每隔一天 every other day；on alternate days；every two days -每隔二天 at intervals of 2 days；every 3rd day -连续5天 for 5 consecutive days
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-几乎一个月 for nearly a month -足足的一个月 for a full month
-期间不详 for an unknown length of time -期间不明确 for an indefinite period -次2夜 the 2 succeeding nights
-前一夜 the preceding (previous) night ※住院
-住院 enter (be admitted to ) hospital；entering (admission to ) hospital；go (be taken ) to hospital -住院时 at the time of one's admission to the hospital
-10年前因治疗肺炎而住院 be hospitalized 10 years ago for treatment of pneumonia ※出院
-出院 leave hospital；be out of hospital； be discharged (dismissed) from hospital （6）在1960年他患了胃病，在医院治疗16天后痊愈。
In 1960 he experienced stomach trouble from which he recovered completely after being treated in a hospital for 16 days. ※治疗
-彻底医治 cure (a disease) completely (radically) ；effect a radical cure -作许多种治疗 try many treatments (for)
-忽视肿瘤，并且不接受治疗 ignore the tumor and refuse treatment -在家里接受治疗 have domiciliary treatment
-述说过去一再使用盘尼西林治疗淋病 give a history of repeated treatments with penicillin for gono in the past.
-自医 try (doctor) oneself；try home treatment ※受~治疗
-服用抗高血压药剂 receive antihypertensive drugs
-使~服抗结刻剂 put one on antituberculosis drugs before one goes surgery -替~打一支盘尼西林 give one a shot of penicillin -经过顺利 have an uncomplicated course -开刀后经过顺利、满意、不顺、(不)良 postoperative course was uneventful,satisfactory, stormy, (un)favorable -become convalescent
ex1：He did not receive any specific therapy but was treated symptomatically.
ex2：Past history revealed an episode of gonorrhea in 1957 which was successfully treated by antibiotics.
六、现症历Present Illness
（1）他在1960年9月生了病；疲劳渐渐加重，周身不适，并且体重减轻。
He became ill in Sept. 1960, with gradually increasing fatigue, general malaise and loss of weight. ※疾病的发生
-开始头痛 started having the headaches
-开始发生紫绀 began having episodes of cyanosis -开始感觉疲劳 began feeling tired
-变成稍一用力即会喘息 became breathless on the least exertion -发觉开始过度疲劳 noted the onset of excessive fatigue
-晚餐时饮酒差不多一定会引起发作 a supper drink almost invariably provokes an attack -不能恢复以前的那种活力 fail to regain one's previous vitality and vigor
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-开始觉得比以前更加容易疲倦 began to fell more easily fatigued
ex1:The disease began (occurred ; started) 3 months ago. It progressed , slowly but steadily until today.
ex2: In the spring of 1958 he first noticed (noted; perceived; recognized) easy fatiguability. ※初发病型
ex1: He became increasingly subject to fits of temper. ex2: He suddenly developed weakness in the right leg. （2）她的膀胱过敏症消失，但在1960年秋天复发。
Her symptoms of bladder irritability subsided, but recurred in the autumn of 1960. ※病征
-有疼痛和已述的症状 pain plus the symptoms already mentioned -想把症状和~关连起来 attempt to correlated symptoms with~ -症状自然消退 symptoms spontaneously regressed
-症状消失(并未缓和) symptoms disappeared (did not abate) -症状忽缓忽急 symptoms waxed and waned from time to time -不留意症状 give the symptoms no concern
-忽略( 不理) 症状 disregard (dismiss) symptoms
-对症状不甚留意 do not pay much attention to the symptoms
-对孩子们显得不关心、冷淡 one appeared uninterested and uninformed about one's children -呕吐是~发病的前驱症状 vomiting heralded the onset of one's symptoms -~的病有伤寒的样子 one's illness assumed the character of typhus -再发（have a) relapse；recur; recurrence
-疾病无再发征象 no evidence of recurrent disease -同一症候再发 the return of the same symptoms
ex1: He had (presented; developed; showed; manifested) mild symptoms of diphtheria. ex2: There have been concurrent heartburn and eructation. ※无~症状
ex1: The carious tooth has persisted for years without clinical symptoms.
ex2: He continued remarkably free of symptoms except for aural discharge until Nov. 1961. （3）他记得一年前，在同一季节里，有过一次同样的发作。 He remembered a similar attack a year before in the same season. ※发作
-一时性眩晕 transitory attacks of dizziness -发作不规则 attacks are variable
-发作变了型态 the attacks changed pattern -患急性关节炎 have acute attacks of arthritis
-发作多半在夜间发生 attacks occurred chiefly at night -患2次肺炎 had 2 episodes of pneumonia
-发生癫痫样的发作 developed seizures of an epiletic nature -发作前后觉得舒适 feel well between attacks
-平均继续了3~4分钟 lasted on average 3 to 4 minutes -一年来没有发作 have been free of attacks for one year
-发作停止(消失，完全消失)了 attacks ceased ( subsided, clear up completely)
ex1: A similar attack appeared in the following morning. It ran the same course as the first one.
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ex2: The most recent episode occurred approximately one month before his first visit to the clinic. ※发作时间
-B随A A is followed by B : B follows A -A与B同时发生 A is associated with B -和~有关系 have (make) relation to~ -和~不相关 have (make) no relation to~
-似乎与姿势、咳嗽、过度用力无关 appeared unrelated to position, coughing,or straining.
ex1: The attacks were preceded by 3 or 4 hour prodromes of nausea, abdominal distention, diarrhea or constipation, followed by 5 to 6 hour period of cramping abdominal pain and bile-stained vomiting, terminated by transient diarrhea.
ex2: The pain was described as being of a cramping nature and sometimes appeared to be related to the ingestion of cold water or milk.
（4）每天服用pyrazinamide 4次，每次75mg.后，咳嗽减少，痰亦减半，热度 也降低。
With pyrazinamide, 75 mg. 4 times daily, there was improvement of cough, a 50 per cent decline in sputum, and a reduction of fever. ※症状的减轻和消失
-转佳 take a favorable turn ; take a turn for the better ; improve -显著减轻 decrease drastically (markedly)
ex1: Such attacks usually subside promptly with rest, in an hour or so , sometimes in a few minutes.
ex2: The swelling of the legs disappeared within about a week.
（5）疼痛发生于饭后，便秘发生后，疼痛更加厉害，期间也较长。
The pain came on after meals and became more severe and lasted longer with the onset of constipation. ※症状的恶化
-恶化 take a bad turn ; take a turn for the worse; be aggravated (exacerbated) -显著地恶化 became noticeably worse -渐趋显著 became increasingly apparent
-黄疸总是恶化 have frequent exacerbations of jaundice -病入膏肓 one's case is incorrigible
-病状时愈时犯 one's illness hangs in the balance
ex1: During the last 6 weeks he has observed progressive shortness of breath on exertion. ex2: The pain was aggravated by exercise and alleviated somewhat by lying down. （6）他的一般情形，一直没有变化。
His general condition continued without change. ※症状无变化
ex1: He remained about the same a yesterday.
ex2: His headache has persisted (continued) to date ( the present).
Exercise1
1.家族历无先天性疾病。
2.据他说，他家里没有人患与此相同的病。 3.家族历无特别记载事项。
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4.他有出血倾向。
5.从家族历看来，母方有血友病的遗传。 6.他出生于健康而无精神疾遗传的家庭。 7.他父亲的死因不明。
8.他在28岁时，死于肺结核。 9.他在发病后5天就死了。 10.他在清晨1点25分去世。 1.
a)The family history revealed (disclosed, showed, indicated) no congenital disease. b)No F.H. of congenital disease was elicited (present). c)There was no history of congenital disease in the family. d)The family had no history of congenital disease.
e)There was nothing in the F.H. suggestive of (to suggest) congenital disease. f)There was no congenital disease in the family history. 2.
a)According to his statement, no other members of his family have ever had (contracted) the same disease.
b)From his statement, there was no similar disease in the other member of his family.
c)He stated (said, related, claimed, alleged, affirmed) that no other members of his family were similarly affected. 3.
a)The family history was noncontributory (unavailable). b)F.H. was not remarkable (contributory).
c)F.H. revealed nothing remarkable (particular, significant, worth recording) d)No particular data were available about the family history. e)There was no relevant family history. f)F.H.:Nothing relevant was indicated. 4.
a)He has a bleeding tendency. b)He has a tendency to bleed. c)He is inclined to bleed. 5.
a)F.H. revealed that hemophilia is transmitted (inherited) on the maternal side. b)Judging from the family history, hemophilia ran in the maternal line.
c)In the family history there was a hemophiliac tendency on the maternal side. 6.
a)He was born in a healthy family without any evidence of hereditary psychosis. b)He was (descended) from a family, healthy and free from hereditary psychosis. c)He came from a healthy family without the slightest trace of hereditary psychosis. 7.
a)The cause of his father's death is unknown (uncertain, undetermined). b)His father died from an unknown cause. c)His father died without definite cause.
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8.
a)He died at the age of twenty-eight of pulmonary tuberculosis. b)TB caused (brought about) his death at 28. c)He died of TB in his 28th year. 9.
a)He died 5 days after he became sick.
b)Five days after the onset of his illness he died. c)After an illness of 5 days he died. 10.
a)He died at 1:25 a.m.
b)He was found dead in bed at 1:25 a.m. c)His respirations ceased at 1:25 a.m. 七、陈诉 Complaint （1）陈诉的写法
ex1：因为以前患过结核病，他有时诉说咳嗽、胸部不舒服和疲劳。 Having suffered from tuberculosis in the past, he complained occasionally of coughing, chest discomfort, and prostration.
ex2：她在1961年住院，诉说最近发生中胸部痛、呼吸短促和心悸。
In 1961 she was admitted to the hospital complaining of (with complaint of ；because of ) mid-chest pain of recent onset, breathlessness and palpitations. （2）~感
-恐惧(眩晕、恶心、寒颤)感 a sensation of fear (giddiness, nausea, chill) -异物(压迫、窒息、烧灼、寒颤)感 foreign body (oppressive, strangling, burning, chilly) sensation (feeling)
-喉头的痒感 itching sensation in one's larynx -模糊不舒服的感觉 vague ill feeling
-咽喉上的束紧感 a feeling of constriction in one's throat
-在咽喉右边的微痒感 a tickling feeling in the right side of the throat
-在~后头部的特殊、难堪的感觉 a peculiar, weighty feeling in the back of one's head
-在右上腹部深处的模糊不舒适感 a vague sense of unease deep in the right upper abdominal quadrant
ex1：她近来感觉，似有东西压在膀胱上。
She has recently had (experienced) a sensation of something pressing on the bladder. ex2：他面部有麻木感。
He has a feeling of numbness of his face.
（3）主诉：应尽可能引用病人的话，说出现症的主要症状，经过期间和找 医师看病的原因。记述需扼要简明并避免含糊语句，常用可用 简写的方式。
ex1：从昨晚饭后，病人一直感觉寒战。
Patient has had chills after dinner since last evening. ↓
可简写为Chills since last evening. ex2：主诉：胃肿胀已4个月。 C.C.：“Swelling of the stomach“ for 4 months.
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ex3：2,3个月来，一做工就感觉呼吸困难和眩晕。 For 2 or 3 months, dyspnea and dizziness on work. （4）病历的申述
-不完全可靠 be not entirely reliable -不甚明晰 be not clearly defined -有些模糊 be somewhat vague -无法获得 be unobtainable
-不能申述适当的病历 can give no adequate history -混乱不很肯定 be uncertain and confused
ex1：关于既往症，他不能提供可靠的报告。
He could not give reliable information concerning former illness. ex2：因为他有精神激动，无法获得可靠的病历。
Because of his mental agitation, no reliable history could be obtained. （5）因~病而转入~科治疗
ex1：她因为在皮肤科住院治疗未见转好，而被介绍过来。
She was referred because there had been no relief with dermatologic treatment, including hospitalization.
ex2：此病人现年27岁，是刚离婚的经产妇，经一所地方医院诊断 为阴道肿瘤而转入本院。 The patient was a 27-year-old recently divorced multipara referred from a district hospital with a diagnosis of a vaginal tumor. （6）全身状态
-精力缺失 lack of energy
-只诉说全身无力 complain only a slight generalized weakness -觉得遍身无力 feel week all over
-不可言状的眩晕 nondescript dizziness
-胸骨下方的不舒服灼感 substernal burning discomfort -饭后腹上部窘迫感 postprandial epigastric distress -心脏部疼痛 precordial pain
-胸内苦闷或重压感 precordial oppression；pressure on the chest；tightness in the chest -全年性的过敏性鼻炎 perennial allergic rhinitis -季节性的支气管性喘息 seasonal bronchial asthma
-一直不断地说胃痛和头痛 incessant complaints of stomach pains and headaches
-尤其喝一杯牛奶后，有些不舒服的饱胀感 some uncomfortable full feeling especially after drinking one glass of milk
-偶而一时丧失意识 have occasional blackouts -肩僵硬 stiff shoulder
-觉气闷，觉气息不舒 feel stifling (suffocating)
-感觉疲乏 become tired ( fatigued, weary)；have a tired feeling；feel languid -觉全身寒栗 feel a cold shuddering pass all through~ -觉得浑身发冷 fell a chill creep over~ -头晕目眩 one's eyes swim in one's head
-(~的)脚麻木 have a charlie horse (in one's leg) ex1：他差不多不断地诉说饭后呕吐。
He complained almost ceaselessly of postprandial nausea.
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ex2：全身虚弱，而腿痛变得很厉害。
There was general debility, and pain in the legs become excruciating.
exercise2
1.从前他一天抽一包烟，现在抽得更多。 2.10年来，他一直喝大量的酒。 3.他曾戒过酒，但无法戒掉。 4.他每在晚餐时，喝一点酒。 5.他滴酒不沾唇。
6.他一向操劳过度，以致患病。
7.他一连工作8小时，也不会感觉疲倦。 8.这婴儿是经过足月的怀孕后，正常生产的。 9.他因身体欠佳，一直到40岁才结婚。 10.她已结婚5年，仍未生育。 11.他早睡迟起。 1.
a)He used to smoke a package of cigarettes a day, and now he smokes more than that. b)In the past he smoked a pack of cigarettes every day and now it is on the increase. c)Formerly he smoked daily a pack of cigarettes but now a little more than that. 2.
a)He has a history of excessive alcoholic intake during the past 10 years. b)He has drunk hard ( to excess; immoderately) for 10 years. c)He has been a heavy( hard; great) drinker since 10 years ago. 3.
a)In spite of everything( Though he had tried) to stop drinking, he did not succeed. b)He had abstained from drinking, but he still found it hard to rid himself of the habit. c)He had given up drinking once, but without a complete success. 4.
a)He drinks a little at supper time.
b)He always takes small evening drink( cups). c)He drinks some wine at supper. 5.
a)He does not drink at all. b)He does not touch glass.
c)He is a teetotaler( total abstainer). 6.
a)He used to overwork and this caused his illness.
b)As a result of constant overwork in the past he became ill. c)His sickness was induced by constant overwork. 7.
a)He could work 8 hours running without getting tired. b)He did not get tired working 8 hours straight.
c)He could work 8 hours at a stretch without fatigue.
d)He could work for eight consecutive hours without feeling tired.
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8.
a)This infant, having been at full term, was born without any difficulty. b)This infant was given a normal birth after full gestation. c)This infant was born at full term with normal delivery. 9.
a)He did not get married until forty because of his poor health. b)Because of physical weakness he remained unmarried until 40. c)Physical weakness prevented him from getting married until 40. 10.
a)She has been married for 5 years, but she still remains sterile. b)She has been married for 5 years, but has never been pregnant. c)She has no child after 5 years of marriage. 11.
a)He goes to bed early but rises late.
b)He has a habit of going to bed early and getting up late. c)He is used to going to bed early and rising late. 八、发烧 Fever
（1）3天来，口腔温度从摄氏37度6分，一直升到摄氏40度。 The temperature has risen steadily from 37.6°C to 40°C orally over the past 3 days. ※发烧
-发烧 become feverish; have a temperature -发高烧 have a high fever
-平常有微热，有几次升到38.4度 have low-grade (slight) fever to 38.4°C on a few occasions -没有发烧 be afebrile; have no fever
ex1:在发烧期间，他的平均体温是摄氏39度。
He ran a febrile course with an average temperature of 39°C. ex2:他在患病期间尿量减少，并且发烧。
He was obliguric and feverish (febrile) throughout the course. ※体温升高
-体温上升 have an elevation of temperature
-发高烧伴随恶寒 have high temp. associated with chill -体温升升，有恶寒 have chills with high temperature
ex1: 体温升到摄氏39度2，腹部也明显地膨胀了起来。 The temp. rose( went up ) to 39.2°C and the abdominal distension became marked. ex2:最近8天的口腔温度升到37.8°C，但后来一直在37.2°C以下。 The oral temp. was elevated to 37.8°C during the past 8 days, but thereafter remained below 37.2°C.
（2）大约在4月底，他的体温，自然地降到摄氏37度。 About the end of April, his temperature dropped to 37°C spontaneously. ※体温降低
-体温急速下降 one's fever falls (abates; declines) promptly -体温开始减低 fever began to remit
-体温似乎是减退了 fever seemed to abate
-体温降到正常 fever dropped (was reduced) to normal
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-体温慢慢地下降(上升) with slow lysis ( cirsis) of fever -体温一天一天地低下来 fever became lower day by day
ex1:2天前的体温几乎恢复正常，今天再升到摄氏38.3度了。 The fever, which went down almost to normal 2 days ago, rose to 38.3°C again today. ex2:病发后10天就退烧了。
Fever disappeared 10 days after onset of illness.
（3）他的直肠体温，下午一直停留在摄氏40度。
He continued to have a temperature with spiking in the afternoon to 40°C by recutum. ※体温不退
ex1:已发烧10天；但最后3天未高过37度2分。 Fever was present for 10 days; it did not exceed 37.2°C during the last 3 days. ex2:最初24小时的体温，在摄氏37.2与38.3度之间。 The temperature during the first 24 hours varied between 37.2°C and 38.3°C. 九、食欲 Appetite, 体重 Weight
（1）他说他胃口一直很好，什么东西都能吃。
He stated that he had always had a good stomach and could eat anything. ※食欲良好
-过食 eat too much ( to excess ; heavily) ; overeat; be intemperate in eating -吃得多 (胃口大开地吃) eat profusely ( with a good appetite) -保持良好食欲 retained an excellent appetite -食欲增进 one's appetite improved
-食欲有节制 (食欲旺盛，贪食不饱) have a moderate (good, enormous) appetite -无食欲障碍 one's appetite is undisturbed -食不过饱的人 a moderate ( spare; light) eater -过饱的人 a heavy (great; hard) eater -食量 capacity for eating
ex1:他的食欲良好，但他平常的吃食习惯，由于口里伤处而中断。
His appetite was good, but the sore place in his mouth interrupted his usual eating habit. ex2:他对食物有无法控制的喜好，用膳时喝很多水。
He had an uncontrollable mania for food, drinking water freely with the meals. ※无食欲
-无食欲 have no (little) appetite ( for food); lose ( have no) relish for one's food; loss ( lack) of appetite; loss of interest in food
-发觉( 有点) 食欲不振 noted ( minimal) anorexia
-食欲不定( 无食欲障碍) one's appetite is variable ( undisturbed) -食欲反复无常 have a capricious appetite
-食欲不佳 have a poor (feeble; weak; delicate) appetite -胃口变得更加不好 became more anorexic -失去平常的食欲 lose one's usual appetite
-食欲减退 appetite decreases ( reduces; declines; falls off)
-吃得少 eat poorly (sparingly) ;take little food; poor food intake -不想吃 be disinclined to eat -取食不规则 eat irregularly -停吃 cease eating
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-促进食欲 improve (stimulate; sharpen; whet) the appetite ex1:他无胃口，只吃了一点点东西。
He had no appetite and only picked at the food.
ex2:他的胃口不如以前，甚至以前喜欢吃的也不例外。
Meals and drinks taste no more as before, and he is indifferent even to his favorite food. ※未进食物
ex1:他整天没有吃什么，只吃几口稀饭。
He eats nothing for a whole day, but he takes some mouthfuls of rice gruel. ex2:他从前天中午起，就没有吃东西。
He has tasted no food since noon the day before yesterday. （2）他诉说非常口渴，但一点食欲也没有。
He complains of his thirst hard to release, while he has absolutely no appetite. ※口渴
-口渴 be (feel) thirsty
-口一直很渴 continue to have excessive thirst -喝大量的水 drink water generously
-对碳酸饮料发生不寻常的爱好 develop an unusual craving for carbonated beverages -要~少喝茶水 be advised to decrease one's tea drinking （3）食欲正常，但体重却在一年之内减轻了4公斤。
In spite of the normal appetite, he lost 4 kg. in weight over a period of one year. ※体重减轻
-住院时体重 admission weight
-最高(最低)体重 maximal ( minimal) weight
-体重减少，但未知多少 weight loss of undetermined amount -通常在夏季体重减轻 usually lose weight in the summer months -体重以惊人的速度减少 lose weight with alarming speed -体重始终一样 weight remained stationary (steady) -体重不变 weight is stable ( unchanged) -体重维持不变 weight is well-maintained
-体重老是50公斤 one's weight is constant ( maintained) at 50 kg.
-虽然食量增加，体重却减轻了6公斤 lost 6 kg. in spite of increased intake of food ex1:他在上2个月内，体重减轻了8公斤。
He developed weight loss totalling 8 kg. in the previous 2 months.
ex2:他的胃口变得很大，食物热量增加2倍，但体重却减轻了10公斤。 His appetite became ravenous and his caloric intake doubled, yet he lost 10 kg.
exercise3
1.他想不起患过什么病。
2.他自幼健康，不曾患过大病。 3.他没患过白喉。
4.他否认在军队时，得过性病。 5.他说幼年时一直闹病。
6.他除患高血压一年外，无其它病诉。 7.他在生后6个月，种过痘。
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8.他因身体虚弱，容易生病。
9.在1957年，他因治疗胸膜炎，住过院。 10.他在开刀后5天，便出院了。 11.他因阑尾炎开过刀。
12.去年他患了肾脏炎，但经过良好，现已痊愈了。 1.
a)He could not remember (recall) what disease he has ever had. b)He had no memory of ever having had any disease. c)He had no recollection of any previous disease. 2.
a)He has been thoroughly sound since his childhood, and has never had any serious disease. b)He has been in good health from his childhood and has had no history of serious disease. c)He has been healthy without any serous disease since his childhood. 3.
a)He had no past (previous; prior) history of diphtheria. b)His P.H. showed no (did not show) diphtheria. c)He did not have a history of diphtheria. d)There was no diphtheria in his P.H. 4.
a)He denied that he contracted V.D. during his military service. b)He denied contracting V.D. while he was in the army. 5.
a)He said that he was often ill in his childhood.
b)He said that during( throughout) his childhood he was always troubled by disease. 6.
a)He states that there is no complaint other than hypertension lasting for a year. b)He is free from any disease except for one year history of hypertension. c)Apart from hypertension of one year's duration he is in good health. 7.
a)He was vaccinated (inoculated) against smallpox when he was six months old. b)He received( took; underwent) a smallpox vaccination at six months of age. 8.
a)Because he is frail, he is prone to illness. b)He is delicate and susceptible to disease.
c)He is liable (predisposed) to get sick, because of physical weakness. 9.
a)He was admitted to the hospital for treatment of pleurisy in 1957. b)He was hospitalized for pleurisy in 1957.
c)In 1957 he went to the hospital to have his pleurisy treated. 10.
a)Five days after an operation, he left the hospital.
b)He was discharged( dismissed) from the hospital on the 5th postoperative day. c)He left the hospital 5 days after he underwent an operation. 11.
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a)His P.H. revealed an appendectomy. b)He had (underwent) an appendectomy.
c)He had an operation ( a surgery) for appendicitis. d)He was operated for appendicitis.
e)He gave a P.H. of appendectomy performed. 12.
a)He suffered from nephritis last year, but its course was uneventful and now he was cured perfectly.
b)He had nephritis last year, and after favorable course he made a full (complete) recovery and regained his health.
c)Last year he developed nephritis which ran an uneventful course and he recovered completely with no sequela ( residual). 十、睡眠 Sleep
（1）发作通常发生于饭后1~2小时，但也时常把病人从睡梦中弄醒。
Attacks usually came on one or two hours after meals, but also frequently wakened the patient from sleep. ※睡眠障碍
-非常爱睡 be unusually sleepy -贪睡 be fond of sleep
-无法控制的嗜睡 uncontrollable somnolence (-cy) -易醒 be easily wakened
-时常在晚上醒过来 often wake up at night. -不能熟睡 sleep is not sound
-晚上睡得不很熟 do not sleep well at night
-睡觉不能多过数小时 sleep for no longer than a few hours.
-由于呼吸短促睡不着 have sleepless night with shortness of breath
-今年冬天由于夜间性气喘一直失眠 had insomnia this winter due to nocturnal asthma -患失眠症 have (develop) insomnia
-睡眠不足 want( lack) of sleep; insufficient sleep -不易入睡 have trouble getting to sleep
-睡眠无多大的障碍 sleep is not greatly disturbed -失眠病人 insomniac
ex1:他不能***数分钟以上，即使静脉注射镇静剂，也不能睡觉。
He was unable to sit still for more than a few minutes, and sleep was impossible even with intravenous sedatives.
ex2:因为他有点挂虑他的病，最近一直睡眠不佳。
His sleep has been poor lately due to a slight anxiety about his illness. （2）他非常容易入睡，特别是晚睡时为然。早上则总是起不来。
He falls into a sleep very easily, especially when sitting up late. He has always had difficulty in getting up early in the morning.
ex1:他总是感觉疲倦，每天大约需要睡12个小时。
He felt chronically tired, requiring about 12 hours of sleep a day. ex2:他老是想睡，但从来不曾在8点后才睡。
He is always inclined to go to sleep, and he never goes to bed later than 8 o'clock.
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十一、神经精神系统 Neuropsychiatric
（1）他数星期来，有好几次在眩晕前，意识突然发生变化。
He had several sudden alterations in consciousness preceded by dizziness for several weeks. ※神经症状
-一般用语 vertigo, dizziness, dizzy spell, syncope, fainting, sleepy, drowsy, lethargic, insomnia, hiccough, convulsion, seizure, trembling, involuntary movement, numbness, weakness, incoordination, clumsiness of motion, tingling, unsteadiness in walking, difficulty in walking, paresthesia, anesthesia, paralysis, myalgia, thick speech, aphonia ex1:他发觉，说话障碍逐渐厉害起来。 He noted a progressive speech impediment. ex2:他不能用病侧脚尖站着。
He was unable to stand on tiptoe on the affected limb.
（2）他的情绪容易突变，且会无缘无故地愠怒和哭泣。
He is liable to sudden changes of mood and would sulk and cry for no apparent reason. ※抑郁
-一般用语 despondent, gloomy, worried, disgusted, discouraged, scared, fearful, low, afraid, angry, blue ; cheerful, optimistic, pessimistic, satisfied, stable, fluctuating, hilarious -喜欢小题大做的 fussy -好管闲事的 noisy
-吹毛求疵的 fault-finding -自负的 conceited -很势利的 snobbish -自私的 selfish -吝啬的 stingy
-气量大的 broad-minded -慷慨的 generous -好心的 kind-hearted
-心情变幻不定而抑郁的 be moody and depressed
-患有极痛苦的忧虑 have an attack of excruciating anxiety ex1:His mood was appropriate.
ex2:His mood was mainly euphoric and expansive. ※思考能力
-一般用语 think less clearly, decreased speed of thinking, decreased clarity of thought, flight of ideas, loss of mental vigor , mental apathy -再也不能集中心力 can no longer concentrate
-发觉集中力减退 noted waning powers of concentration ex1:她发觉在读习和写作时，注意力有点不易集中。
She noted only slight difficulty in concentrating while reading and writing. （3）他迷妄，有生动的幻觉，并且不能说出连贯的病历。
He was deluded, vividly hallucinated, and unable to give any coherent history. ※精神异常
-一般用语 hallucination, delusion of persecution(被害妄想), mental confusion, disorientation, mental aberration, negativism, loss of memory, amnesia, mutism, etc.
-老是发出痴呆、不适当的笑声 frequently exhibit silly inappropriate laughter
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-对其他小孩残酷无情 behave brutally toward other children -变为难于驾御 become unmanageable
-发觉个性显著变化 a definite personality change is noted
-精神失常逐渐厉害起来 have gradually progressive mental deterioration. -发觉记性障碍有2个月 noted memory impairment for 2 months. （4）她显示出心情、情绪反常的显著倾向。
She manifested a marked tendency toward destructiveness and disturbance of mood and affect. ※性癖异常
-一般用语 emotional instability, tendency to worry, hot temper, temper outbursts, irritable, shy, fussy, quarrelsome
-情绪非常窘迫 be in severe increasing emotional lability -心神不安宁,坐立不安 be restless and fidgety -动辄生气 be easily moved to anger -脾气暴躁 have temper tantrums
-深怀自卑感 harborn deep feelings of inferiority ex1:病人的健康状态良好，情绪似使正常。
The patient is in good condition and seems to be emotionally undisturbed. ex2:他老是神经过敏，自从心悸发生后更加厉害。
He was always a 'nervous' person but more so since the onset of palpitation.
exercise 4
1.他不知道病的起因。
2.他的病是慢慢地发作的。 3.他上腹部突然痛起来。
4.他的病，是在住院前3星期开始的。
5.约在7个月前，他第一次发觉，吞东西不如以前顺利。 6.3天前他开始咳嗽，一直继续到现在。
7.从去年8月，他开始有食欲不振，体重减轻和发烧的症状。 8.他的症状是喉痛和无力。 9.他的消化系统，完全无症状。 10.他的老病---风湿症，又发了。 11.3天前，他的病开始好转。 12.昨天他的病更加恶化。 十二、疼痛 Pain
（1）当上楼梯时，突然痛了起来，并且持续不止。
The pain came on suddenly while walking up the stairs and it was persistent. ※疼痛的发生
-感觉疼痛 feel (have; suffer from) a pain; pain is felt in ; feel painful
-头痛 have a headache; be troubled with a headache; feel a pain in one's head -患剧烈头痛 have a nasty (bad) headache -时常头痛 be subject (a martyr) to headaches
-有撞击似的两侧性头痛 have bilateral pounding headaches
-头痛逐渐地变为频发( 较不严重) headaches gradually become more frequent (less severe) ex1:咀嚼时，有偶发的、暂时的、不可言状的疼痛或敏感。
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There is occasional, transient, nondescript pain, or sensibility during mastication. ex2:该齿对于压迫作痛，且有钝麻如咬的疼痛。
The tooth became sore to pressure and there is a dull gnawing pain. ※发生时间
ex1:Epigastric pain comes immediately after meal. ex2:Colic pain came on and off since yesterday.
ex3:This pain has been relentlessly postprandial, regardless of the character of her meals. ex4:The joint pains were present mainly at night, with relief during the day.
ex5:The mild frontal headaches were usually present upon awakening, but not severe enough to require analgesics.
ex6:The pain usually commenced within 30 minutes after meals and lasted 1 to 3 hours. ※发生原因
ex1:He described the pain as dull and aching, occurring approximately once a week, unrelated to food intake, and radiating to his back.
（2）起初疼痛无变化，但数小时时变成发作性的痛。
The pain initially was steady, but after several hours became episodic. ※疼痛的种类
-恒常（痛） constant -间歇（痛） intermittent -偶（痛） occasional -急性（痛） acute -钝麻（痛），闷（痛） dull -搏动性的 throbbing -抽搐（痛）tic -抽（痛） twinge -锐（痛），急（痛） sharp
-刺（射）痛 stabbing ( shooting) pain -钻锥（痛） boring -穿刺（痛） piercing -窜（痛） darting
-被咬样的（痛） gnawing -似裂（痛） tearing (splitting) -胀（痛） bursting
-刀割样（痛） knife-like -痉挛（痛） crampy -拉（痛） dragging
-箍（痛） girdle-like ( constricting) -痛得打滚 writhing -极痛的 excruciating
-切割的（痛） lancinating -绞性痛 colic (colicky pain) -剧痛 severe ( pungent; intense) -感应痛 referred pain -坠痛 bearing-down pain
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-发生遍身的酸痛 develop diffuse body aching -有剧烈的骨盘痛 have exquisite pelvic pain -牙痛频发 continual bouts of toothache
-一阵阵剧烈的牙痛 the pangs of a toothache
-带有胸膜炎性状的右胸痛 right-sided pain of a pleuritic character -发生阵痛性的疼痛 have labor-like pains ex1:这痛是持续不变的，若刺的剧痛。
The pain was steady, sharp and boring in nature ( character). ex2:该痛和她以前诉过的疼痛一样。
The pain was identical with what she had complained of. ※疼痛再发
-pain reappears ( relapses); pain breaks out again; a return of the pain ex1:左乳房下的疼痛时时再发，而不是持续性的。
The pain under the left breast recurred at intervals but was not constant.
ex2:疼痛很少在他晚餐后再发，同时喝牛奶或服用抑酸剂，对于疼痛并无影响。
The pain rarely returned after his evening meal and it was not affected when he ingested milk or antacid.
（3）有时疼痛放射到右下肢后侧，一直到脚部。
At times pain radiates down the back of the right lower extremity to the foot. ※疼痛放射
-pain radiates ( travels) to ~; pain radiating from ~ to ~; radiation of the pain to ~ ex1:疼痛放射到腰部周围，躺下时缓和些，站立时加剧。
The pain radiated around toward the groin, relieved by lying down and aggravated while standing.
ex2:住院那天，他感到疼痛加剧，并且放射到右肩胛和肩部。
On the day of admission he experienced increasingly severe pain with radiation to the right scapular area and shoulders.
（4）这疼痛局限于正中线，因吃力的劳动而加剧。
The pain was confined to the midline and was aggravated by heavy labor. ※疼痛部位
-疼痛存在于 the pain is limited to; the pain is located ( localized; situated) in (or over) ; there is localized pain in ~
-遍在痛 generalized ( general; extensive; unlocalized) pain ex1:起初，疼痛遍及整个腹部，后来它局限于右上象限。
At first the pain was generalized in the ( whole) abdomen; but it subsequently localized to the R.U.Q.
ex2:起于右下腹部的疼痛，不久便局限于左上腹部。
The pain, which began ( originated) in the R.L.Q., soon became localized in the L.U.Q. ※疼痛减轻
-疼痛减轻 pain is relieved by , relieve ( ease, allay, alleviate, assuage, abate, soothe) the pain, pains decrease ( grow less, go down , fall off) -疼痛减轻了 the pain became lighter
-疼痛的严重度减少 the severity of the pain waned -疼痛未停止 the pain did no ease
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ex1:疼痛和腹泻都减轻，但自从那时起，他就感觉疲倦和衰弱。 The pain and diarrhea abated, but he felt tired and weak since then. ex2:胸部痛有时因改变体位而减轻，但只是暂时而已。
The chest pain is sometimes relieved by a change of position, but only temporarily. ※疼痛加剧
ex1:虽然没有肋膜带性状，但这痛因深吸气而显著加剧。
The pain was markedly accentuated by deep inspiration, although it was not pleuritic in nature. ex2:当他在晚上作偏右侧睡时，疼痛最厉害。
The pain is most severe at night when he lies on his right side.
exercise 4
1.他不知道病的起因。
2.他的病是慢慢地发作的。 3.他上腹部突然痛起来。
4.他的病，是在住院前3星期开始的。
5.约在7个月前，他第一次发觉，吞东西不如以前顺利。 6.3天前他开始咳嗽，一直继续到现在。
7.从去年8月，他开始有食欲不振，体重减轻和发烧的症状。 8.他的症状是喉痛和无力。 9.他的消化系统，完全无症状。 10.他的老病---风湿症，又发了。 11.3天前，他的病开始好转。 12.昨天他的病更加恶化。 1.
a)He does not know why he got sick.
b)He does not know the cause of his disease. c)He has no inkling of the cause of his disease. 2.
a)The onset of his disease is gradual.
b)His disease is gradual(insidious) in onset. c)His disease occurred(commenced) gradually. 3.
a)He had (suffered from) a sudden epigastric pain. b)An acute(abrupt) pain was felt in his upper abdomen. c)He experienced a sudden attack of epigastralgia. 4.
a)His illness was first noted 3 weeks prior to admission. b)His illness began(started; occurred) 3 weeks P.T.A. c)He dated the onset of his illness 3 weeks P.T.A. 5.
a)About seven months ago, he first(initially) noticed (noted; perceived; found) that he could not swallow as smoothly as before( usual).
b)Approximately seven months ago, he found for the first time that he had difficulty in swallowing.
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c)For the first time he was aware(cognizant) of dysphagia about seven months ago. 6.
a)He began to have cough 3 days ago and it has continued since then. b)His cough which started 3 days ago has persisted up to the present.
c)Three days ago he developed a cough (began or started coughing) and it has lasted until today. 7.
a)His disease began last Aug. with loss of appetite, loss of weight and fever. b)His illness started in Aug. last year with anorexia, loss of weight and fever. c)The symptoms of anorexia, weight loss and fever began last Aug. 8.
a)The characteristics of his disease are sore throat and weakness. b)Sore throat and weakness are the peculiarities of his disease. c)His disease is characterized by sore throat and weakness. 9.
a)He was entirely free of digestive system.
b)Absolutely no abnormality was found in his digestive system.
c)There was absolutely no symptom referable to his digestive system. d)In reference to digestive system he was quite asymptomatic. 10.
a)He had a recurrence (a relapse; another attack) of his old rheumatism. b)His old rheumatism occurred again.
c)Rheumatism, his old complaint ( fault), recurred. 11.
a)His condition began to improve 3 days ago.
b)Three days ago his condition began to make favorable progress. c)His condition turned (changed) for the better 3 days ago. 12.
a)His condition(disease) became(got) worse yesterday. b)His condition took a serious turn yesterday.
c)His condition took a turn for the worse yesterday. 十三、呼吸Resp., 咳嗽Cough, 痰Sputum （1）他诉说被呼吸困难苦恼了好多天。
He complains of difficulty of breathing, which annoyed him for several days. ※呼吸
-呼吸困难 breathe hard (with difficulty) ; have difficulty in breathing ( respiration) -呼吸困难 dyspnea (夜间性 nocturnal, 发作性paroxysmal) -安静时（运动性）呼吸困难 dyspnea at rest (on exertion)
-常发生发作性夜间呼吸困难 frequent episodes of paroxysmal nocturnal dyspnea -呼吸困难突然厉害起来 have sudden increase in dyspnea
-患轻微的运动性呼吸困难 have some mild exertional dyspnea -患急性呼吸困难 have an acute attack of dyspnea -无呼吸困难 have no respiratory embarrassment -偶有心悸 have occasional palpitations
-心悸反复发生 have recurrent episodes of palpations
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Ex1:第2天早晨，病人呼吸变为非常困难和衰弱。
The next morning the patient became extremely dyspneic and weak. Ex2:走快或上楼梯时，他总是气促的。
He always becomes short-winded when walking hastily or going up stairs. （2）这个病人常常咳嗽，并且吐出灰色的臭痰。
The patient coughs very often and expectorates foul-smelling grayish sputum. ※咳嗽
-种类 short, sharp, small, dry(hasty), moist, constant, painful, irritable, spasmodic, wheezing, distressed, rasping
-咳个不停 have a fit of coughing; cough oneself into a fit (fits) -苦咳个不停 have a hard (racking; convulsive) cough
-患4天干燥发作性咳嗽 experience a 4-day episode of dry paroxysmal cough. -2岁时开始有间歇性烦咳 intermittent hacking cough started at 2 years old -咳嗽减少了 one＇s cough diminished
-发生轻度无痰的干咳 develop slight nonproductive cough -有点（很多）咯血 have minimal (massive) hemoptysis. -咯出一点血 cough (expectorate; spit) up (out) a little blood -开始咯出黑血斑点 began coughing op flecks of dark blood -呕血 vomit blood
Ex1:他偶而咳嗽，但不曾感觉胸部痛、发烧或体重减轻。
He coughed occasionally, but he has never experienced pain in the thorax, fever, or loss of weight. Ex2:最近6个月，他的咳嗽一直带有轻微咯血。
For the last 6 months, he has been coughing with slight hemoptysis. ※痰
-种类 thin, thick, fetid, serous, frothy, tenacious, viscous, mucous( mucoid), mucopurulent, transparent, seropurulent, rusty
-中等量（多量、大量）带有灰白色痰的咳嗽 moderate amounts ( a great deal, large quantities) of grayish-white sputum
-痰涌上咽喉，有酸味 phlegm wells up in the throat and tastes sour -痰堵住嗓子了 phlegm blocked the windpipe -半杯黄色痰 one half cup of yellowish sputum
-吐脓性，偶而带血的痰 produce purulent, occasionally blood-tinged sputum -开始有点咳嗽，并且有约3公撮的血痰 began to have some cough and produced about 3 ml. of bloody sputum.
-一点也咳不出痰 do not raise any phlegm at all -咳痰停止了 expectoration ceased Ex1:他开始有少量带血丝的痰。
He began to expectorate small amounts of blood-streaked sputum. Ex2:他的咳嗽已经不像以前那样厉害，痰里也不再有血斑了。
His cough was not so severe as it had been and sputum was no longer flecked with blood. 十四、胃肠 Stomach & Bowels
（1）当空腹时，他感觉胃里不舒服。
He has a certain disagreeable felling in the stomach when it is empty. ※胃
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-胃不调 upset stomach
-消化不良 have bad (impaired: defective) digestion; suffer from indigestion ( dyspepsia)
-胃有毛病 have a disordered stomach ( stomach disorder); something is wrong with one’s stomach.
-因过食而伤胃 injure one＇s stomach by overeating oneself -觉食物积滞胃中 feel heavy on the stomach -食物不易消化lie (sit) heavy on one’s stomach Ex1:自从那时起，消化便已失常。
Thereafter, the digestion was not really good.
（2）曾有过一时性的恶心和呕吐，但并没有食欲不振或体重减少发生。
Transient nausea and vomiting was present, but no anorexia or weight loss occurred. ※恶心
-欲呕 feel nauseated
-有晨吐 have morning sickness
-夜吐（饭后恶心） nocturnal (postprandial) nausea -晕船（车） be sea- (car-) sick
-有点恶心 have (experience) some nausea -严重的作呕 have considerable retching
-里急后重时发生恶心和呕吐 have a spell of N & V while straining at stool -患食欲不振和恶心 be anorexic and nauseated
-偶而恶心和呕吐 develop occasional nausea and vomiting -老是溢酸，感觉腹胀 burp all the time, feel bloated
-吐出清净透明的胃容物 with vomiting of clear gastric contents -呕吐停了，消失了vomiting stopped (ceased), cleared -止吐 settle the stomach -打噎 belch (eruct; eructate)
Ex1:这病人恶心，曾呕吐了含有胆汁液体数次。
The patient developed nausea and vomited bile-stained fluid on several occasions. Ex2:当要呕吐时，他发觉有严重的腹上部痛和剧烈的头痛。
With the advent of vomiting, he noted severe epigastric pain as well as severe headache.
（3）在第2天中午，她开始呕吐，随后呕吐胆汁质物。
At noon on the following day she stared vomiting food, which was followed by bile-stained material. ※呕吐
-在病发时呕吐2次 vomit twice at the onset -极度反胃 regurgitate food violently
Ex1:一小时后，他吐出不含血液的水质样东西。
One hour later, he vomited watery material containing no blood. Ex2:有时这病人在发作最厉害时，呕吐1、2次。
Sometimes the patient vomited once or twice at the height of the attack. ※呕吐物
Ex1:昨天早晨的呕吐物，被形容为含有未消化的食物和绿水，无血。
The vomitus of yesterday morning was described as containing indigested food and
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greenish water with no evidence of blood.
Ex2:最初的呕吐物是透明的，但据说住院治疗之前的呕吐物，带有褐色。 The vomitus was initially clear but just before hospitalization was said to brownish. （4）他开始有多次、带泡沫和臭味的大便。
He began to have frequent, frothy, foul-smelling stools. ※大便
-解大便 open (relax; evacuate) the bowel; have a passage -有便意 have a call of nature
-有1次（2次）大便 have a motion (two motions) -没有大便 be constipated
-平均每天大便12次 averaged 12 stools daily
-发觉粪便中有很多血 noticed gross blood in one＇s stools
-开始一天解8次松的多脂粪便 began to pass 8 loose greasy stools per day -大便增加到一天4~5次 stools increased in number to 4 or 5 daily -更换尿布时有些粪便 have some stool in each diaper change
Ex1:大便次数减少了，但他仍然每天继续有2~3次大量的稀大便。
The stools became fewer in number but he still continued to have 2~3 large loose stools daily.
Ex2:住院前2个月，她发觉黑色大便，但却把它忽略过去了。
Two months before admission she had noticed black stools but she disregarded them. ※大便检查
-种类 ordinary, dry, hard, loose(soft), large, watery(liquid), formed, formless, frothy, mucous, bloody, rice-water, pea-soup, tarry
-臭味 odorless, extremely foul, sour, putrid, less offensive in odor, offensive but no excessively foul
-颜色 black, tarry, brownish-black, brown, red, green, yellow, light-brown, grey-white (clay-colored)
Ex1:大便的粗细和硬度正常，且从未呈黑色。
The stools were of normal caliber and consistency and have never been black. Ex2:大便颜色很淡，并且软如泥。
Stools were very light in color and of mushy consistence. （5）他诉说间歇性腹泻与便秘交替发生。
He complained of intermittent diarrhea alternating with constipation. ※便秘
-便秘 suffer from constipation -惯性便秘 habitual constipation -时常便秘 be always constipated
-有便秘倾向 have a tendency to be constipated
-只有灌肠才能缓和严重的便秘 one＇s severe constipation was relieved only by enemas
Ex1:便秘很难治，他以前常乞灵于泻药。
The constipation was very obstinate (stubborn) and he resorted to the frequent use of cathartics. Ex2:她的便秘逐渐严重起来，同时发觉到粪便直径变细。
She became progressively more constipated and noted a narrowing in the caliber of
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the stools. ※腹泻
-晨泻，水泻，粘液性腹泻，慢性腹泻 diarrhea (morning, watery, mucous, dysenteric, chronic) -腹泻 diarrhea (轻症 mild,拖延的 protracted, 无法控制的 uncontrolled, 难医的intractable) -患腹泻 suffer from diarrhea; have ( an attack of ) diarrhea; have loose bowels -短期的腹泻发生了 a brief episode of diarrhea occurred
-开始泻腹(自然消失，于两天后消失) diarrhea commenced ( spontaneously disappeared, cleared after 2 days)
-偶而泻肚子 have occasional diarrhea
-腹泻厉害，在3~7次之间 diarrhea varied in severity from 3 to 7 B.M. -不得不服药 be obliged to take physics
-腹泻未因吃脱脂牛奶而转佳 received skim milk without any improvement in the diarrhea -用泻药 use a purgative
Ex1:他患腹泻，每天有8~10次带有粘液，脓和鲜红色血的大便。
He developed diarrhea with the daily passage of 8~10 stools containing mucous, pus, and bright red blood.
Ex2:以前他患过同样的腹泻，但从来没有这么严重过。
He previously had similar attacks of diarrhea but they were never so severe.
exercise 5
1.几个星期来，他感觉稍微工作即疲倦。 2.他容易疲倦，不能工作。 3.他头痛，微感不适。 4.昨天晚上他发高烧。
5.昨天他的体温伴随寒战，升到摄氏40度2分。 6.今天早上，他的体温降到摄氏36.8度。 7.住院前的体温，总是在36.8到40度之间。 8.4天来，他发热总在摄氏38度4分左右。 9.他的热度，老是不退。 10.他头痛发热。 1.
a)He feels tired (fatigued) after slight exertion for many weeks.
b)Even a trifling work would make him weary during these last weeks. c)He becomes tired on slight exertion for these weeks. 2.
a)He is easily fatigued. Consequently, he is unable to work.
b)He is extremely fatiguable at all times and therefore can do nothing.
c)He is troubled by easy fatiguability, and as a result of this he cannot perform any work. 3.
a)He feels heavy in his head and slight discomfort.
b)He has a headache and is rather indisposed (out of sorts).
c)He is troubled by a headache associated with slight indisposition. 4.
a)He had a high-grade fever last night.
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b)He had an attack of high fever last night. c)He was sick( ill) with high fever last night. 5.
a)The fever, together with shaking chills, rose (went) up to 40.2°C yesterday. b)There was an elevation of fever to 40.2°C with shaking chills yesterday. c)Yesterday, the fever increased ( was elevated) to 40.2°C with shaking chills. d)Yesterday his body temperature accompanied with a chill reached 40.2°C. 6.
a)This morning his fever fell ( dropped; decreased; subsided; abated) to 36.8°C. b)There was decrease in his fever to 36.8°C this morning. 7.
a)The temperature P.T.A. had been in the range of 38.6° to 40°C.
b)The temperature P.T.A had ranged ( varied; fluctuated; run) from 38.6° to 40°C. c)P.T.A., he had had a range in temperature from 38.6° to 40°C. 8.
a)He has continued to have a temp. of 38.4°C for 4 days. b)He has had a steady temp. of 38.4°C for 4 days. c)He has been ill with a temp. of 38.4°C for 4 days. 9.
a)His fever has never fallen.
b)His fever has remained unchanged. c)His fever has been steady ( constant).
d)He has continued to have a spiking (persistent) fever. 10.
a)He suffered from headache and fever.
b)He had headache associated (together) with fever. c)He was troubled by headache and fever. 十五、排尿 Urination,生殖器 Genitalia
（1）他诉说，在两侧鼠蹊部和睾丸有拉痛，且有夜尿，小便时有灼热感，间或放红色的尿。 He complained of a drawing pain in both groins and testicles, nocturia, burning on urination and the intermittent voiding of red-colored urine. ※尿
-种类 colorless, clear, transparent, translucent( semitransparent), opaque, milky( opalescent) cloudy( turbid), orange, greenish, dirty blue, green, yellow( amber; straw), red, bright red, brown yellow, dark-brown, brown-dark, light brown, pale yellow, faint pale, clay-colored, patty-colored -排便 micturate; make( pass) water; void; piss
-一夜有2次小便 have nocturia twice nightly ( a night) -这次住院时解出一个结石 pass a stone on this admission -小便浑浊 one＇s urine is thick( colored)
-解出极浑浊，乳白色的尿 the passage of highly turbid, milky urine -频尿 frequent urination( micturition)
-无法忍受的频尿 intolerable frequency of urination -终末性血尿 terminal hematuria
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-终末尿带有几滴血 urine terminates with a few drops of blood -排尿痛 micturition pain
-解尿时左腰疼痛 have pain in the left loin on micturition -小便流势良好 void with a g
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