1、Clinical DialoguesPart 1.Part 1.Woman complained of tightness in abdomen associated with belching(嗳气)wind which did not relieve feeling.Symptoms usually began between 5 and 6 p.m.lasting several hours.Relieved by white mixture.(D=Doctor,P=Patient)D:Does the pain come oncome on in the night?come onco
2、me on:to startIf a cold,headache,or some other medical condition is coming on is coming on,it is just startingis just starting.e.g.I felt a cold coming on.我觉得开始感冒了。P:Not often.D:When it comes onWhen it comes on,do you get up?P:Yes,I get up and walk around and it relieves.PainPainI haveI have a a hea
3、dacheheadache.I havehave a a splitting headachesplitting headache.（我头痛得像要裂开了。）I haveI have a a stomach-achestomach-ache.I feelI feel a a dull paindull pain in in the stomach.I seem to haveI seem to have pain all pain all overover.（我似乎浑身都痛。）ImIm achachinging all over all over.（我浑身都痛。）Its Its a a dull
4、 dull sort ofsort of pain,and pain,and I dont know whats I dont know whats causing it.causing it.Its notIts not a a sharpsharp pain;just pain;just sort ofsort of a dull ache.a dull ache.It all beganIt all began yesterday.It startedIt started two days ago.It came onIt came on last night.It hurtsIt hu
5、rts terrible.terrible.（痛得很厉害。）Its been hanging aboutIts been hanging about for for nearlynearly a week.（这已经持续了将近一个星期了。）It keeps hanging onIt keeps hanging on.（这老是不好。）ItIt sort ofsort of hung onhung on.（这似乎不见好。）Or:Just off and onJust off and on.（就是时断时续。）Ive got a pain inIve got a pain in my back.（背疼）
6、My eyes My eyes have beenhave been sore sore.（眼睛发痛）MyMy left foot hurtshurts.My tooth My tooth is is aching upaching up again.again.I feel shivery and I feel shivery and Ive got aIve got a sore throatsore throat.（我觉得怕冷发抖，而且喉咙疼痛。）The The painpains been keepings been keeping me awake.me awake.D:Does a
7、nything Does anything but the white mixture help ithelp it?P:Ive beenIve been on a strict dieton a strict diet for for six months.I never never touchtouch milk.on a dieton a diet:If you are on a diet,you are eating special kinds of food because you want to lose weight.（为减肥）节食touchtouch:If you do not
8、 touch a particular kind of food or drink,you never eat it or drink it.吃；喝e.g.Drink?No,she never touches the stuff.喝酒？不，他从不喝这种东西。D:Does any position help Does any position help you?you?P:No,It comes onIt comes on after after tea,about five.I have my main meal midday.D:Have you been sick?Have you bee
9、n sick?（你呕吐过吗？）(=Any vomiting?)P:Only at the beginning I was very sick then.A sick sick person has an illness or some other problem with their health.To be sickbe sick means to bring up food through your mouth from your stomach.e.g.I think Im going to be sick.Note that“George is being sick”means“Geo
10、rge is bringing up food from his stomach”;“George is sick”means“George is ill”.However,“George was sick”can mean either“George brought up food from his stomach”or“George was ill”.VomitVomit has the same meaning as“be sick”.VomitVomit is a fairly formal word.e.g.She was stricken with(被.折磨)pain and be
11、gan to vomit.Throw upThrow up:In conversation,some people say throw up throw up instead of“be sickbe sick”.e.g.I think Im going to throw up.Ive been throwing up.Ive been throwing up.我一直呕吐。我一直呕吐。D:Do youDo you feelfeel sick sick?（恶心吗？）(=Have you got any feeling of nausea?)(=Are you feeling nausea?)P:
12、Yes,I I feel sickfeel sick but I but I cant cant be sickbe sick.（我经常恶心，但不再呕吐。）Feel sickFeel sick:To feel sick means to feel that you want to be sick.e.g.Flying always makes me feel sick.Note:ILLILL and sicksick are both used to say that that someone has a disease or some other problem with their hea
13、lth.e.g.Davis is ill.Your uncle is very sick.A sick child Most British speakers do not use ill in front of a noun unless they are also using an adverb(副词).For example,they do not talk about“an ill woman”,but they might talk about“a seriously ill woman”.a terminally ill patient.American and Scottish
14、speakers sometimes use ill in front of a noun without using an adverb.We had to get medical help for our ill sisters.D:Does the pain gogo through to the back?P:No,but it goes goes under my armpits.（腋下）D:Whats yourWhats your weight weight been doingbeen doing?（你的体重最近怎样？）(=Have you lost weight recentl
15、y?)P:Ive lostIve lost one and half stone but Ive beenIve been on a on a fat-free diet diet for six months.(or:My weight fell from 65kg.to 50 kg.)Stone:a unit of weight in Great Britain,14 pounds(6.4 kilograms)英石英国重量单位，等于14磅(6.4公斤）D:Whats yourWhats your appetite appetite likelike?（你的胃口怎样？）(=How about
16、 your appetite?)(=Do you have any appetite?)Whats(your)/(the)Whats(your)/(the)?/?/What seems to be theWhat seems to be the?Whats Whats your appetiteyour appetite like like?Whats yourWhats your complaint?(complaint?(你你有什么不舒服？有什么不舒服？)=Whats yourWhats your trouble?trouble?=Whats theWhats the trouble?tr
17、ouble?=WhatsWhats bothering you?bothering you?=What seems to beWhat seems to be bothering you?bothering you?=What do youWhat do you complain of?complain of?=Whats theWhats the matter with you?matter with you?=What seems to beWhat seems to be the matter?the matter?=WhatsWhats wrong with you?wrong wit
18、h you?=What What hurts you?hurts you?=What seems to beWhat seems to be the the problem?problem?=What seems to beWhat seems to be the the trouble?trouble?P:Poor as ever.(=Ive got a bad appetite.)D:What about yourWhat about your bowelsbowels?（大便如何？）(=Are your bowels acting properly?)(=Are your bowels
19、regular?)P:I gogo twice a day,in the morning.D:Is this a life-long habitlife-long habit?P:Yes.D:What doWhat do the the motionsmotions look likelook like?Well-formed,Well-formed,firm?firm?（大便什么形状？成形，坚实吗？）P:Yes.D:What about theWhat about the color?color?Has it changed?Has it changed?P:No.D:Are they da
20、rk?P:Yes.D:Any sign of blood?Any sign of blood?P:No.D:Do they float on the Do they float on the water when you water when you flush the flush the lavatorylavatory?（你冲洗厕所时，它漂浮在水面上吗？）P:No.D:Have you noticedHave you noticed an an unpleasant smell?unpleasant smell?P:No.D:Have you noticedHave you noticed
21、 any any difference in your difference in your waterwater?（你排尿有无异常？）P:No.D:Do you have toDo you have to get up in get up in the night?the night?（你夜间起来上厕所吗？）P:Once.D:Your waterwater hasnt been darker?P:No.D:Do youDo you smoke?smoke?P:10 a day.D:Do youDo you drink?drink?P:Not much.D:Have you any other
22、Have you any other troubletrouble?P:No,mymy anginas been very s been very goodgood.（我的心绞痛已经好了。）Ive Ive not had much trouble with that not had much trouble with that for for two years.（这两年没大犯过。）-Or:I feel absolutely rottenI feel absolutely rotten.（我觉得身体很不舒服、非常虚弱。）If you feel or look rotten,you feel o
23、r look illI feel a bit off colorI feel a bit off color.（我觉得有点不舒服。）Here,color means reddish-pink color in ones face that shows that ones health is good.面色；血色I feel so ill.I feel so ill.I feel rather unwell.I feel rather unwell.I feel very bad.I feel very bad.I really feel terrible.I really feel terri
24、ble.I think Im dying.I think Im dying.（我难受极了。）Im feeling rather out of Im feeling rather out of sortssorts these days.（这些天我觉得身体很不舒服。）If you feel out of sorts,you feel slightly unwell,discontented,or annoyed.身体不适；心情不佳；烦恼Im under the weather.Im under the weather.（我不舒服。）If you say that you are under un
25、der the weatherthe weather,you mean that you feel slightly ill.My whole body feels weak.My whole body feels weak.I just feel all pooped out.I just feel all pooped out.（我只觉得精疲力竭。）be pooped outbe pooped out:to be very tired;used mainly in informal American English.D:Youve also had trouble with your le
26、g?P:Yes,they thought it was thrombosis(血栓).D:When did you first start When did you first start withwith your your tummytummy trouble?trouble?（第一次胃病是什么时候发作的？）TummyTummy:the human stomach or belly 肚子，胃P:About 14 years ago.D:The same,but more bothersomebothersome now?（现在是否更厉害?）P:Yes,its tighter.its tig
27、hter.（病情更重了。）Warning:1)You do not say that someone becomes“iller”or“more ill”.You say that they become worseworse.2)You do not use illill or sicksick to say that someone has received an injury.You say that they are injuredinjured or hurt hurt.D:Have you ever beenHave you ever been jaundiced?jaundice
28、d?（得过黄疸吗？）P:No.D:Is yourIs your tummy swollen tummy swollen when you feel likewhen you feel like this?this?（犯病时肚胀吗？）P:It feels as thoughIt feels as though Im Im going togoing to burst.（我觉得肚子快要爆炸了。）D:Well,Id like toId like to have a look have a look at youat you.（检查一下）Will youWill you get get undress
29、ed and lie on the undressed and lie on the couch pleasecouch please?（请脱去衣服，躺在检查床上。）Or:Or:Lie down on the couch there.Lie down on the couch there.Let me just see.Let me just see.Lie down on the couch there.Lie down on the couch there.Let me examine your belly.Let me examine your belly.Would you mind
30、taking off all your clothes except your pants(for men)/except your pants and bra奶罩(for women)?Lie on the couch and cover yourself with the blanket.Well,lets see.Well,lets see.Now Now slip offslip off your coat and shirt,your coat and shirt,please.please.Strip toStrip to your waist,please.your waist,
31、please.把上身把上身衣服脱掉衣服脱掉RollRoll your sleeve your sleeve upup.SlipSlip your shoes your shoes offoff and and hop hop upup on the bed.on the bed.Slip offSlip off your shoes and your shoes and socks.socks.Let me checkLet me check your lungs and heart.Let me listen toLet me listen to your lungs and heart.L
32、et me examineLet me examine your stomach.Let me soundLet me sound your lungs.your lungs.(叩诊叩诊)Unbutton Unbutton your shirt and your shirt and let let me listen tome listen to your your lungs.OpenOpen your mouth and say your mouth and say“Ah”.“Ah”.OpenOpen your mouth please,your mouth please,and and
33、show meshow me your tongue.your tongue.Put Put this thermometer(this thermometer(体温体温计计)under your tongue.under your tongue.Ill haveIll have your temperature your temperature takentaken.Well,Well,Id betterId better take your take your blood pressureblood pressure.May IMay I take your blood take your
34、 blood pressure?pressure?Let meLet me take your blood take your blood pressure.pressure.Clinical ExaminationClinical ExaminationDuring the examination the doctor asked the following questions:D:Do you suffer fromDo you suffer from heartburn?P:No.D:Have you had any children?P:No.D:Are your hands alwa
35、ys cold and red?P:Yes.A lovely color in the winter!（冬天简直红得可爱！）D:Just hold your breath for a moment.Breathe through your mouth.Show me where you get this pain.Your age?P:72.D:Your Your periodsperiods finished finished when?when?（你什么时候停经的。）P:When I was about 52 or 3.D:Any tenderness here?Any tendernes
36、s here?P:Its a bit sore but not a lot.D:Does it Does it catch catch you at all you at all when you breathe?when you breathe?（你每次呼吸都觉得痛吗？）P:No.D:Have you any pains in your legs?(=Do you have any pains in your legs?)P:I getget cramp cramp（抽筋）a bit when Im in bed.D:More in one leg than the other?P:I ge
37、t it in my right leg;thats my varicose（静脉曲张）leg.D:Apart from this,youve hadApart from this,youve had no other serious illness in the no other serious illness in the lastlast 14 yearsyears?P:No.D:Im going toIm going to take a drop of take a drop of your bloodyour blood and Id like you to Id like you
38、to havehave a a stomach X-ray X-ray.Youll have to come specially,dont eat anything before and drink a white paste which outlines your stomach and well take some pictures.Or:I think wed betterI think wed better give you give you a few tests.a few tests.A blood test A blood test is necessaryis necessa
39、ry.Take your blood countTake your blood count first first,pleaseplease.Youre to haveYoure to have a blood test.a blood test.Im going toIm going to taketake a throat culture so well know for so well know for suresure.You must haveYou must have an electrocardiograph examinationexamination.Well,letsWel
40、l,lets take an X-ray of take an X-ray of youryour chest.Go and have yourGo and have your chest X-X-rayrayeded.BOWELS BOWELS 大便大便Medical words:faecesfaeces,stoolsstools,to,to defaecatedefaecateColloquial words:motionmotion,to have the bowels openedto have the bowels opened Useful questions Useful que
41、stions How often do you have your bowels opened?Is this a life-long habit?What do the motions look like?Are they quite well formed?What about the color?Has it changed?Are they darker in color？Have you ever seen any blood in your motions?Have you noticed an unpleasant smell?Do you ever have diarrhea(
42、腹泻)or constipation(便秘)?Do you have to go in a hurry?（上厕所）Can you hold your motions?（控制排便）Do you have to strain(用力)to pass your motions?(tenesmus)（里急后重,下坠）Do you take laxatives(轻泻剂)?Do the motions float on the water after flushing the lavatory?Do you ever have any pain on passing your motions?Do you
43、get pain before,during or after passing your motions?Do you suffer from wind?Have you noticed any special food upsets your bowels?Have you lost any weight?Descriptive words Descriptive wordsColorColor:black,brown,clay-like,colorless-like rice-water(cholera霍乱),dark brown,green,grey,pale,pea-soup-like
44、,putty-like(油灰样),porridge-like)(麦片粥样)(steatorrhoea脂肪痢),jelly-like,tarry(柏油样),white,yellow,etc.Form and consistencyForm and consistency(稠度):bloody,bulky,dry,fatty,floating,friable,frequent,frothy(泡沫样的),greasy(油脂过多的),hard,hard dry balls,loose,purulent(脓性的),slimy(粘液的),soft,watery,well-formed,worms,etc.
45、AmountAmount:copious,scantyOdorOdor:offensive(very bad)Useful ExpressionsUseful ExpressionsGreetingGreeting “Good morning,Mrs.Rayner,come and sit down.”Asking patients to describe their Asking patients to describe their symptomssymptoms “Well now,how can I help you?”“Well,Mrs.Rayner,whats the troubl
46、e?”“Your doctor says youve been having trouble with your back.Tell me about it.”Collecting casesCollecting casesMentioned above.Directing patients how to undressDirecting patients how to undress “Would you mind taking off all your clothes except your pants(for men)/except your pants and bra(for wome
47、n)?Lie on the couch and cover yourself with the blanket.”“Slip off your shoes and socks.”“Roll your sleeve up.”Directing patients how to Directing patients how to assume appropriate assume appropriate positions positions “Please lie on your tummy.”“Please turn over and lie on your back.”“Roll over o
48、nto your left side.”“Bend your knees.”“Sit up.”“Lean forward.”“Get off the couch and stand up.”“Walk across the room.”painfulpainful:1)You say that something is painful when it makes you feel pain.e.g.a long and painful illness2)If a part of your body is painful,it hurts.e.g.My back is so painful th
49、at I can not stand upright.3)When someone feels pain,you do not say that they are“painful”.You say that they are in painin pain.e.g.He was in pain in pain and could not move into a comfortable position.Part 2.Part 2.D:I see you I see you have hadhave had several several attacks ofattacks of influenz
50、a(流行性感冒).Anything else?Anything else?P:Ive had dizzinessdizziness(头晕目眩)and Ive been sick.If you feel dizzydizzy,you feel that you are losing your balance and are about to fall.To be sickbe sick means to bring up food through your mouth from your stomach.D:WhenWhen did this start?P:Two months ago.D:H
