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自负的科学家和失败的疫苗开发历程 – 译学馆
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自负的科学家和失败的疫苗开发历程

Curing Tuberculosis - The Hero Koch - Extra History - #1

柏林1890年
Berlin, 1890.
会场内围满了医生
Doctors crowd the theatre’s lobby,
他们前来见证历史
they’ve come to see history made.
门票早就卖光了
Tickets are impossible to get.
一位英国医生
One British physician,a man who dabbles in writing,
同时也是伦敦报纸的撰稿人
and is there on behalfof a London newspaper,
求人给他张门票
begs for a seat.
他发现进不去门时想贿赂保安 却碰壁了
When he fails to secure one, he first tries bribery and then stealth
他试图偷偷溜进去
to make it past the ushers.
也被发现了
Both attempts fail.
大门关闭了 他知道自己进不去了
The doors close, and he admits defeat.
亚瑟·柯南·道尔注定无法入场
Arthur Conan Doyle will remain outside,
但会场里 伟大的德国科学家罗伯特·科赫
but inside, the great German scientist Robert Koch
开始了他结核病疗法的演示
begins to demonstrate his cure
《历史小讲堂》
for Tuberculosis. Intro music [Birth of the People]
本视频由“青少年体检计划”筹划播出
This series is brought to you by Child and Teen Checkups program.
每个孩子每年至少体检一次
Every child needs a check upat least once a year.
如果你住在明尼苏达州 他们会提供帮助
If you live in Minnesota, they can help.
到getctc.com了解更多信息
Learn more at getctc.com
十九世纪 结核病有很多名字
The nineteenth century had many names for Tuberculosis.
流传最广的名字是“痨病”
The most popular was’Consumption’,
因患者明显的体重减轻症状而命名
named after patients’ dramatic weight loss. Another,
另一个名字是“白瘟” 因为患者有着苍白的脸色
‘The White Death’, because of how pale sufferers became.
还有一个是“亡灵指挥官”
And also ‘The Captain of the Men of Death’
因为死于该病的巨大人口数量
due to its prolific body count.
19世纪的欧洲和美国
To live in nineteenth centuryEurope and America,
笼罩在结核病带来的死亡阴影中
was to live among tubercular death.
那个世纪 多达1/7的德国人死于结核病
During that century, up to one in seven Germans died of the disease. And,
在一些年份
during some years,
1/4的伦敦人口因结核病丧命
a full quarter of London’s deaths were attributed to TB.
肮脏拥挤的城市和工厂
The crowded and unclean natureof cities and factories,
两者都给结核病提供了很好的传播环境
both on the rise, proved an ideal environmentfor transmission.
而且在这样一个公共卫生尚未普及的年代
And in an erabefore public hygiene campaigns,
加之缺乏对“细菌理论”的广泛认知
or the widespread belief in germ theory, coughing, sneezing,
在公共场合咳嗽 打喷嚏和随地吐痰是常态
and spitting in public were the norm.
随地吐痰特别常见
Spitting was especially commonplace though,
而且由于城市居民鼻腔里存在大量煤烟粉尘
and considered healthy,
随地吐痰被认为是健康的行为
given the amount of coal smoke that coated city dwellers’ sinuses.
人们随便吐在公交上
People freely spit on street cars,
甚至是美国国会的议席上 真恶心
or even the floor of the United States Congress, gross.
结核病发病缓慢
It came on slow,
潜伏在患者肺部 时间长达数月乃至数年
lodging deep into the patient’s lungs and lying dormant for months or years. First,
患者最初的症状是反复的咳嗽
the patient would presenta cough that came and went.
然后是消瘦无力
Then weight loss,and weakness.
直到有一天
One day, they might finda telltale drop of blood
他们在手帕上发现了血迹
in their handkerchief.
卧床不起和死亡随之而来
Frailness and death would follow.
没什么管用的疗法
There was little to do.
鱼肝油 鸦片和奎宁可以减轻痛苦
Cod liver oil, Opium and Quinineeased the suffering,
但无法治愈疾病
but didn’t fight the disease.
许多患者住进疗养院
Many patients chose to visit sanitoriumsand places with
和空气好的地方
“good air”:
比如高山地带或气候干燥的地方
Alpine regions or particularly dry climates,
其他人则采用未经确认的偏方
while others subscribeto unproven regimens
比如冷水泡澡或者静卧
of cold baths or immobility. Some,
还有些病急乱投医的人接受了手术
seeking any kind of relief, underwent surgeries too gruesome to describe here.
场面太血腥就不描述了
大多数情况下
Mostly though,
人们找到了延长生存期的方法
people found a way to live for as long as they could.
但终究 患者还是逐渐步向死亡
After all, it killed slowly,
因为发病缓慢 结核病被认为是“仁慈”的病
and in this,it was almost considered”merciful”,
患上此病的人 可以在家人好友的簇拥下死去
providing the”good death”surrounded by friends and family
这在维多利亚时代是个奢求
that was so desiredin the Victorian Era.
结核病甚至成了时尚
The disease evenbecame fashionable,
这与波希米亚人和浪漫主义者有关
associated with Bohemians and Romanticists.
前后几位知名艺术家相继死于此病
After several prominent artistsdied from the disease,
女人开始在脸上扑粉来模仿苍白的样子
women powdered their facesto mimic the pale look.
小说和歌剧中的天生一对
Novels and operastold of doomed lovers
总会因为白瘟天人永隔
destined to be separatedby the White Plague.
罗伯特·科赫医生应运而生
Enter Doctor Robert Koch,
他是德意志帝国的英雄
Hero of the German Empire.
他是治愈结核病的理想人选
He was *exactly* the kind of person you’d expect to cure Tuberculosis.
他出身贫寒
He’d come from humble beginnings,
在普法战争期间担任外科医生
serving as a surgeon during the Franco-Prussian War,
后来建立了一个国家级医疗项目
and later opening a country medical practice,
他用得到的报酬在家里建了一个实验室
using his profits to build a home laboratory.
然后在后院饲养了一些测试动物
He kept a menagerie of test animals in his backyard,
有鸡 兔子 豚鼠 白鼠
ranging from chickens to rabbitsto guinea pigs and white mice.
从这时开始
他着手研究一种在他社区肆虐的疾病
And it was there that he began to study a disease that ravaged his rural community:
炭疽病
Anthrax.
一经深入研究 就得到了重大突破
His big break camewhen he developed, and demonstrated
一种在实验室纯培养条件下
a process for isolatingand growing bacteria
分离和培养细菌的过程
in pure laboratory cultures,
被他用作识别炭疽细菌的技术
techniques he used to identify the anthrax bacteria. And,
而且这项操作还让科赫在微生物研究方面取得了进展
that done, Koch forged aheadwith his research on microbes,
很快就得到了严谨学者的美誉
quickly gaining a reputationas a meticulous scientist.
当他缺乏证明理论的工具时
And when he lacked the toolsto prove what he needed,
就去发明个新工具
he just invented new ones!
他找到了在明胶和琼脂上培养细菌的新方法
Finding novel ways to grow bacteriaon gelatin and agar,
还发明了摄影显微镜
and developinga photographic microscope,
以后医生就不用依赖手绘图分辨微生物了
so doctors need not rely on drawings.
但成就不仅仅是这些发现本身
But these discoverieswere no mere accomplishments.
他通过识别特定细菌
By identifying a specific bacteria
确认了炭疽病的原因
as the cause of anthrax,
并证明他可以利用这种细菌来感染健康的动物
And proving he could use that bacteria to infect healthy animals,
由此 他的“细菌致病理论”得以证实
he had conclusively provedthe’Germ Theory of Disease.’ Moreover,
此外 他将初步实验结果形成了四个假说
he turned these initial experimentsinto his four postulates.
作为检验是否由特定微生物
Criteria to demonstratewhether a specific microbe
引发特定疾病的标准
caused a specific disease.
可以说 这个赤脚大夫奠定了细菌学的基础
This country doctor had, essentially, helped found Bacteriology.
他继续使用这些假说
He would go onto use these postulates
分离了孟买的霍乱细菌
to isolate Cholera bacteria in Bombay,
然后在1882年的一个一鸣惊人的声明中
and in a blockbuster 1882 announcement,
他透露已发现导致结核病的病原体
revealed that he’d found the pathogenthat caused Tuberculosis.
这个声明引发了轰动
And that last declaration caused a sensation.
结核病是欧洲最大的杀手
Tuberculosis was the greatest killer in Europe,
确定了发病原因 意味着可能找到治愈方法
and identifying its cause suggested that a cure might be on the way.
毕竟 当科赫首次分离出炭疽细菌时
After all, that’s what had happened when Koch first isolated Anthrax bacteria.
这样的事情就发生了
分离出炭疽细菌的5年后
And five years later,Louis Pasteur had produced a vaccine.
路易斯·巴斯德就生产出了一种疫苗
这也是科赫研究结核病的原因
And that, in many ways, was why Koch was pursuing tuberculosis.
他很生气巴斯德抢在他前面找到了治疗炭疽病的方法
He was annoyed that Pasteur had found a cure for Anthrax before he could.
并且愤怒于巴斯德几乎没有引用他的研究
And furious that Pasteur had barely cited his research in doing so.
两人没有共同庆祝这一伟大突破
Instead of jointly celebrating the discovery,
他们陷入了和对方的纠缠
the two entered a bitter lifetime feud,
在论文期刊上进行人身攻击
trading barbs in scientific journals.
科赫认为巴斯德草率自负
Koch seethed that Pasteur, who he saw as
抢占了他的研究领域
sloppy and self-aggrandizing, had encroached on his territory. Besides,
此外 科赫是德国人 而巴斯德是法国人
Koch was German, and Pasteur, French.
这场争斗牵扯了民族自豪感
There was national pride on the line. Tuberculosis,
科赫决定将结核病作为终身成就
Koch decided,would be his greatest prize.
如果他能找到有效的白瘟治疗方法
If he could find an effective treatmentfor the White Plague,
他将名垂青史
his legacy would be assured.
他甚至可能获得一家自己的研究所
He might even get his own institute,
就像他讨厌的对手巴斯德那样
like his hated rival, Pasteur.
八年后 他终于取得了突破
And after eight years, he finally had a breakthrough.
当给豚鼠注射一种物质时
A substance that, when injected into guinea pigs,
该物质切断了病灶的营养来源
starved the pathogen to death, by killing the infected
通过饿死感染病灶治愈结核病
flesh it fed on,
被杀死的病灶会随咳嗽排出体外
allowing the dead flesh to detach and patients to expel it via cough.
疗法不是直接杀死致病菌
It didn’t directly kill the disease, though,
但可以阻止疾病的传播
but it took away the ability to spread.
科赫先用动物做测试 然后给健康的人注射
He tested it on animals, then gave doses to healthy subjects
包括他自己
including himself.
没有出现一例副作用
None had a bad reaction, But,
但当他给结核病人注射时
when he gave it to tubercular patients,
引发了高烧
it brought on severe fever, chills,
发冷 并明显减慢了疾病侵蚀的速度
and an apparent slowing of the disease.
一些淋巴结增生的患者
In patients who experienced growthin their lymph nodes,
增生组织消失了
the growths became necrotic.
这个结果很理想
It was a lucky result.
第十届医学大会即将召开
The Tenth Medical Congress was coming up,
他面临着为德国取得伟大科学胜利的压力
and he was under pressure to deliver a great scientific victory for Germany. So,
所以 在1890年
in 1890,
科赫站在柏林第十届医学大会上
Koch stood in a hall full of doctors
一个满是医生的会场里
at the Tenth Medical Congress in Berlin,
公布了他奇迹般的疗法
and unveiled his new wonder remedy,
结核菌素
Tuberculin.
他强调对此的研究并不完善
He stressed that his research was not complete,
而且该疗法对早期病患效果更好
and that the substance worked best in patients whose cases were not too advanced. And,
并且 他坚称
he insisted,
结核菌素的具体成份目前必须保密
the precise nature of the substance must remain a secret at present.
但无论如何
But here at last,
这可能是痨病的针对性疗法
was a remedy that could halt the progress of Consumption.
几个月后他会公开发表疗法的效果
There would be a demonstration in a few months.
消息震动了所有人
The news exploded.
报纸报道科赫找到了结核病的治疗方法
Newspapers announced that Kochhad found a cure.
凯撒大帝向他颁发了德国最高奖项
The Kaiser presented himwith Germany’s highest award:
大十字红鹰勋章
The Grand Cross of the Order of the Red Eagle.
他家和实验室被世界各地来的信件塞满了
Letters from all over the worldflooded his home and laboratory,
希望得到结核菌素
begging for doses of tuberculin.
带着病痛即将被治愈的希望
And sensing an end to their misery, thousands of consumptives
成千上万的痨病患者涌向柏林
flocked to Berlin, creating a public health crisis that necessitated
给公共卫生带来危机
警方不得不出面干预 让患者远离民众
police intervention to keep them away from the populace.
科赫实现了他的愿望
And Koch got his wish: his own infectious disease institute,
他拥有了一所自己的传染病研究所
整整一层可以用来研究结核菌素
with a whole section researching tuberculin.
他们开始生产结核菌素 并开展了人体实验
They began producing the substanceand conducting human trials.
这场公开发表获得了成功
The public demonstration was a success.
房间里挤了满满的医生
The house was so packed,that doctors without tickets,
没有票的医生像柯南道尔一样被拒之门外
like Conan Doyle, were turned away.
幸运的是 柯南道尔
Luckily for Conan Doyle, however,
设法复制了一名在场医生的笔记
he managed to copy notes from a man who attended,
第二天
and the next day,
他还参观了接受治疗的患者的病房
got to visit a ward where tuberculin was being tested on patients.
他拿到报道素材了
His newspaper article was saved!
但他对所看到的一切感到震惊
But Conan Doyle was shocked at what he saw.
患者全身颤抖 剧烈扭动 剧烈高烧
Patients shivering, thrashing, burning with fever,
这个词当时还没发明出来
The term had not been invented yet,
但柯南道尔被目睹的一切震惊了
but he was witnessing them going into shock.
这不是治疗方案
This was no cure.
疗法只是实验性的初期结果
“The whole thing was experimental and premature,”
他在《伦敦每日邮报》发表的文章中警告说
he warned in a piecefor the London Daily Telegraph.
在后续实验中
In a follow-up,
虽然结核菌素杀死了病灶
he said that while the injection may kill diseased tissue,
但病原体毫无疑问仍在体内
it undoubtedly left the pathogen.
不过 低剂量注射部位的肿胀
Due to the swelling at the injection site, however,
可以作为结核病的诊断指征
in low doses, it might serve as a test to diagnose TB.
柯南道尔是为数不多的冷静者
Conan Doyle was one of the few temperate voices.
几个月后 第一次注射实验要开始了
And within months,the first trial doses began going out.
不仅仅是柏林 还有伦敦 巴黎和爱丁堡
Not just to Berlin, but to London, Paris, and Edinburgh,
从私人诊所 疗养院到医院
to private practicesand sanatoriums, as well as hospitals.
报纸记者和民众都在关心第一次注射
Newspaper reporters and crowds gather to watch the first injections.
每个患者应接受多少剂量的注射还不确定
There were no controlsabout how much each patient would receive,
各年龄段的两千多人接受了结核菌素治疗
and over two thousand people,of all ages, received tuberculin.
但此时 配方依然是个谜
But the composition remained a secret.
科赫还是没有公布结核菌素的具体成分
Koch still wouldn’t reveal what was in tuberculin.
这不太寻常 甚至让人感到不安
This was unusual, even uncomfortable.
但科赫是一位享有世界知名度的天才
But Koch was a geniuswith a world-renowned reputation.
一些患者的病情似乎有所改善
Some patients appeared to improve, others,
还有一些 死了
die.
起初 科赫辩解那些病例无论是否接受治疗都会死亡
At first, the latter were dismissed as dire cases that would’ve expired anyway. But,
但是 随着实验开展 治愈率也逐渐清晰了
as tests continue, the numbers began to tell a different story.
虽然有些患者有所改善
Though some seemed to improve,
但真正治愈的只有24人
only around two dozen (24) people were actually cured.
而死亡人数是30人
Thirty (30) had died.
实验失败了
It was a failure. And,
而且 更重要的是
more than that,
有消息泄露称科赫一直在为申请结核菌素专利谈判
news leaked that Koch had been in talks to patent tuberculin,
他要把这笔钱投入新的研究所
using the profits to fund his new institute. Worse,
更糟的是 有研究表明
a study revealed that killing infected tissue
被杀死的病灶没有阻止结核病的传播
didn’t actually stop TB from spreading.
迫于公众压力科赫公开了结核菌素的成分
Under public pressure, Koch revealed the ingredients of tuberculin:
浸泡在甘油中的死亡结核菌的抽提物
dead tuberculosis microbes, in glycerin extract.
随即就逃往埃及躲避民众的怒火
…and traveled to Egypt to avoid the firestorm.
现在事实清楚了 结核菌素无法治愈结核病
It was clear this was not the cure.
虽然柯南道尔预测
Though as Conan Doyle predicted,
这个疗法可以通过观察注射区周围的肿胀
the swelling around the injection area proved a very good test
排查出对该物质过敏的结核病患者
to diagnose TB patients who were allergic to the substance.
科赫的错误源于一些自满和急功近利
Koch’s mistake was one of pride and process.
他过分热衷于获得自我和国家的胜利
In his eagerness to secure a win for self and country,
以至于他放弃了以严谨著称的实验方案
he’d abandoned the methodical practicesthat were his hallmark.
他把科学家的身份带入到了
He’d bought into the myth of a scientist
神话里的英雄 伟人
as a heroic, singular figure,
而不是在社区中通过团队合作做出贡献的人
rather than as a part of a community that advances
这正是我们下期要播出的内容
And as we’ll see next time,
通过团队合作和渐进式创新
it would take that kind of teamwork and incremental innovations
最终治愈了白瘟
to finally cure The White Plague.
[音乐]
[Postulate 5 by Sean and Dean Kiner]
再次感谢“青少年体检计划”赞助这个系列
and Teen Checkups programs for sponsoring this series.
现在结核病并不像以前那么普遍
Tuberculosis isn’t as common as it once was,
但它依然存在
but it does still exist.
儿童应每年接受健康检查
Children should receive a health checkup every year.
医生会通过询问 确定您的孩子是否有感染风险
And doctors can ask questions to find out if your child is at risk.
如果你住在明尼苏达州 在getctc.com了解更多信息
If you live in Minnesota, learn more at getctc.com
如果你住在其他地区 请点击视频详情中的链接
If you don’t (live in Minnesota), click the link in the description below.

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视频概述

急功近利的科学家,放弃了他一贯严谨的研究方法,转向投机取巧,结果自然是名声扫地。

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短尾龙

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审核员1024

视频来源

https://www.youtube.com/watch?v=XP-WXLsnMjY

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