When it comes to medicine, times have changed more than most of us realize. At the tender age of 4, I (and most of my friends) dealt with the itchy, feverish misery that is chicken pox. My dad's generation lived in fear of polio, and his mother dealt with rampant scarlet fever. Thanks to modern medicine, these and many other diseases have been rendered preventable, treatable or are simply far less common than in their heyday. In fact, many diagnoses that were once grimly given are now handled with relative ease, sometimes outright curable. Early detection, pharmaceuticals, vaccines and cutting-edge surgeries have completely revolutionized health care as we know it, making infectious or acquired diseases far less dire than they used to be. Sadly, the Catch-22 of many of these diseases is that treatments exist, but aren't always available in developing nations. So, even if they're curable in the United States or Western Europe, millions still unnecessarily lose their lives elsewhere due to lack of medical care or drug availability. Public health organizations are continuing to chip away at this issue, but it'll likely be a long process.
说到医学，其演变进化的程度可以说超出大多数人的认知。在我还是一个4岁孩童时，水痘会让我痛苦不堪，全身发热、发痒难耐。对我父亲那一代人来说，小儿麻痹症是可怕的。对于祖母而言，骇人的就是她们那个年代肆虐泛滥的猩红热了。多亏了现代医学的发展，许许多多的疾病都已经可以预防和治疗，最不济的也不若从前一般猖獗。事实上，如今人类已经可以相对轻松的治疗那些从前让人感到害怕的疾病，甚至有一些可以完全治愈。正如我们所知，早期检测、药物、疫苗和先进手术等医学手段完全革新了医疗事业的发展，使得传染病及其他后天疾病不再像从前那样棘手。然而令人遗憾的是，我们仍然面临一个两难的处境：尽管拥有相关的治疗技术，但是身处发展中国家的患者们并非都能享有相应的治疗服务。所以，在美国或西欧国家，患有疾病的人可以得到诊治；而在其他缺乏医疗条件、药物供给不足的地区，无数的人因身患疾病而白白地丧失性命。公众健康组织一直在为改善这一局面而进行不懈的努力，只不过路漫漫其修远兮。
Nevertheless, progress has been made. We'll look at 10 diseases that used to spell death for patients, but not so anymore, starting with one that's fairly recent in origin.
不论如何，事情总归是朝着良好方向发展的。接下来，让我们来看看10个曾经属于致命的疾病，就先从离我们年代较近的说起吧。
10.艾滋病
You probably know the basics of human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Back in the disease's terrifying heyday of the 1980s and early '90s, even experts knew precious little about how to treat HIV, which is usually transmitted through unprotected anal or vaginal sex or by sharing drug needles. Common symptoms include rashes, fever, enlarged lymph nodes and a sore throat. Over time, if untreated, a body with HIV loses the ability to fight off infections, which leads to AIDS. Contracting HIV used to be a death sentence, but not anymore, thanks to the introduction of antiretroviral drugs in the mid-1990s. "In the early days, people diagnosed with HIV had a life expectancy of about eight years," says John Brooks, M.D., medical officer in the Division of HIV/AIDS Prevention of the Centers for Disease Control and Prevention (CDC). "Today, a person who is promptly diagnosed with HIV and appropriately treated can look forward to a close-to-normal life span." Modern antiretroviral therapy can be administered in as little as one pill per day, eliminating symptoms, but stopping short at actually curing the disease, of course.
你或许了解艾滋病（获得性免疫综合症AIDS）的病因——人类免疫缺陷病毒的作用机理。19世纪80年代及90年代初期是艾滋病的发病高峰，那时即使是专家们也对应对HIV病毒知之甚少。这种病毒通常是通过共用针管或不卫生的性交方式造成传染。一些常见的患病症状包括起疹子、发热、淋巴结异常增大和喉咙疼痛。感染病毒者一旦没有及时的接受治疗，之后就会丧失抗传染能力，进而发展成为艾滋病患者。HIV病毒过去对人类来说就是一个死亡信号，不过随着19世纪90年代中期抗逆转录病毒药物的问世，它已不再对生命构成威胁。来自疾病控制和防御中心，HIV/AIDS部门的医学人员约翰·布鲁克博士说，过去感染HIV病毒的人只能活8年左右。而如今，感染者及时接受治疗将有望恢复如健康人一般。在现代抗逆转录病毒疗法的帮助下，病人只需每天服用一片药即可消除病症，切实达到治疗目的。
In 2010, AIDS was the seventh leading cause of death among the 25-44 age bracket in the U.S., having peaked at No. 1 in both 1994 and 1995. Yet, the epidemic is far from over, with about 34 million people in 2014 infected around the globe, often unaware they even have HIV or AIDS.
2010年，艾滋病已经成为美国25—44周岁患病者中的第七大致死病因。在1994年及1995年，它更是致命性疾病中的头号杀手。然而，这个传染病的消亡之日还远远没有到来。2014年，全球感染艾滋病者数量增至3400万人，很多人甚至对自己患有HIV或艾滋病浑然不知。
9.肺结核
Ever seen a period movie where the heroine coughs droplets of blood into a hanky? You've witnessed a re-enactment of the disease that was a leading cause of death in the U.S. and Europe in the late 1800s and early 1900s.
你是否看过这样一部电影，里面有主角往手帕里咳出很多血的情节？如果是的话，那你算是见识过人们被这个疾病折磨的样子了。在18世纪末及19世纪初期的欧美国家，它可是主要的致命性疾病之一。
Back in 1892, tuberculosis (TB) was responsible for one out of seven deaths in the U.S. Also known as consumption, TB spreads when a person infected with Mycobacterium tuberculosis coughs, sneezes or otherwise transmits droplets through the air to someone else. Roughly a third of the global population is infected with latent TB, which yields no symptoms and is not contagious in that stage, but probably will be in time. Once it evolves into TB disease, the bacteria usually wages war on the lungs; hence the notoriously bloody cough, as well as chills, night sweats and fever. Antibiotics and upgraded living conditions have significantly contributed to the decline of TB in modernized countries. Unfortunately, it continues to plague developing countries, with roughly 95 percent of TB diagnoses and deaths situated squarely in their borders. However, treatment and containment efforts are making a dent; the worldwide death rate from TB dropped 45 percent between 1990 and 2012. Nevertheless, multi-drug resistant TB is at very high levels.
1892年，每7个丧命的美国人中就有一个是死于肺结核病。肺结核又称痨病。一旦患有结核分枝杆菌的人咳嗽、打喷嚏或通过其他方式将自身液体藉由空气传播给他人，病毒就会发生扩散。大概全球人口的三分之一都患有潜在性肺结核病，这种疾病没有临床表现也暂时不具传染性，不过未来怎样还尚未可知。一旦这种潜在性病症演化为完全的肺结核，病毒就会对人体的肺部造成极大伤害，从而导致人们大量咳血、全身发冷、夜里盗汗和发高烧。在发达国家，抗生素的发明及生活条件的改善极大降低了肺结核的发病率。不幸的是在一些发展中国家，人们依然深受此病困扰，约有95%的肺结核患者及死亡案例来自较为落后的国家。然而，对于肺结核疾病的治疗和遏制工作仍取得了显著进步。在1990至2012年间，其致死率下降了45个百分点。只不过，对于多重抗药性肺结核病的治疗工作就困难重重了。
8.狂犬病
If you're ever bitten by a dog, bat, raccoon or other angry animal, you should hustle to a hospital with haste. Even if the animal is more bad-tempered than rabid, this disease isn't something you want to take a chance on. Once symptoms appear, rabies is transformed into a painful illness that fatally attacks the central nervous system, causing confusion and delirium and eventually death.
一旦被狗狗、蝙蝠、熊或是其他任何凶猛的动物咬伤过，哪怕连滚带爬的，都请你以最快的速度前去医院就诊。同他们的坏脾气相比，狂犬病真的可怕多了，这种病可不是你能冒险尝试的。一旦症状爆发，狂犬病就会即刻转变成为一种令人痛苦的疾病，它将对你的中枢神经系统造成致命的侵害，导致你思维混淆、精神错乱，直至最终死亡。
However, rabies is very treatable as long as it's caught before symptoms emerge. Most people know when they've been bitten by an animal, making the risk easy enough to assess, and post-exposure treatments and vaccines are available to stop symptoms before they start. Awareness and treatment are credited with keeping the U.S. death toll at two or three people per year, down from 100 in the early 1900s.
然而，只要在症状出现之前及时的遏制住病情，狂犬病还是在可控范围之内并可医治康复。大多数人都知道，当被动物咬伤之后，他们可以直观预估咬伤的风险程度，及时采取暴露后治疗措施，迅速前往医院注射疫苗，以期在病症爆发前稳定住病情。早在20世纪90年代初，得益于人们对此疾病的认识加深和治疗普及，使得美国狂犬病死亡人数从每年100人逐渐降至每年2至3人。
7.淋巴腺鼠疫
Also known as the Black Death, the bubonic plague seems too terrifying to be true, but the sad fact is that it killed more than 75 million people in 1300s. The horrific spread began in Asia and worked its way into Europe, where about one-third of the continent's population was infected, suffering through myriad symptoms like apple-sized swellings that oozed blood and pus, aches, pains, vomiting, fever and chills, before dying. Although the initial phase wound down around the 1350s, the disease has continued to periodically pop up around the world.
鼠疫，即为我们所熟知的黑死病，其可怕程度根本无法想象。更可悲的事实是，14世纪因鼠疫而死亡的人数高达7500万人。这一可怕的现象更是逐渐蔓延至整个亚洲，同时渗透至欧洲的各个角落，在那些地方，几乎三分之一的大陆人口都被感染致病。患上鼠疫的人们饱受病症的折磨，苹果般大小的肿块不断从中渗出脓血。无法忍受的疼痛，无止尽的阵痛，不断地呕吐，持续的高烧以及阵阵发寒的身体，直至他们死亡痛苦才得以终止。尽管在14世纪中期，这一恶症已逐渐被人们所掌控，可在世界各地仍会出现周期性的爆发。
We now know that bubonic plague is spread by infected fleas and rats, and is best kept under control with public health and improved sanitation efforts. That doesn't mean it's history. More than 10,000 people contracted the disease in the Congo between 2000 and 2009. Even in the U.S., 56 people caught the plague during that same period (seven died). Antibiotic treatment can now quickly cure this once definite death sentence, but it must be done fast. If the bacteria reach the lungs, it becomes pneumonic plague, which can rapidly turn fatal.
我们知道，鼠疫通过受感染的跳蚤和老鼠传播，通过公共卫生情况的提高以及环境卫生的改善，可以对疫情达到良好的控制。但历史上可并非如此。2000年至2009年，刚果感染鼠疫的人数超过了一万人！甚至在美国，同一时期也有56例市民感染鼠疫的案例，其中有7人因病情严重致死。现代的抗生素治疗法已可以治愈当年被誉为绝症的疾病，但还是需要在病症爆发前期尽早治疗。一旦细菌进入肺部，确诊为鼠疫，将会以超快的速度致死。
6.天花
One of the oldest diseases in the world (Ramesses V of Egypt, who died in 1157 B.C.E. apparently had it), smallpox killed 300 million people worldwide in the 20th century. The condition got its name to distinguish it the "great pox" (aka as syphilis). This contagious disease is spread by face-to-face contact with an infected person. Symptoms include fever, headache and severe back pain followed by telltale red pustules all over the body, which leave pitted scars.
天花是世界上最古老的疾病之一（埃及拉美西斯五世在公元前1157年去世，有着明显的天花症状），它在20世纪使全球3亿人丧命。为了与梅毒相区别，取名为天花。天花是一种传染病，和病人面对面接触就会被传染。症状有发热、头痛和严重的背痛，紧接着红色脓包就会长满全身，留下疤痕。
Smallpox was also the first disease for which a vaccination became available. Britain's Dr. Edward Jenner had heard that milkmaids who had contracted the mild disease of cowpox never developed smallpox. In 1796, he tested the theory by injecting a boy with some pus from a cowpox pustule and saw that it gave him immunity to smallpox. The breakthrough was enormous and paved the way for the science of vaccination. In 1959, the World Health Organization decided to eradicate the disease from the planet by isolating smallpox patients and vaccinating everyone in an area where smallpox was detected. In 1980, the organization declared victory; smallpox was no more.
同时天花也是第一个可以接种疫苗预防的疾病。英国爱德华·詹纳医生听说那些患有轻微牛痘的挤奶女工从未感染上天花。1796年，他做了个测试，将牛痘脓包的脓水注射入一个男孩体内，然后观察到他对天花有了免疫。这个突破发现的意义是巨大的，它为接种医学奠定了基础。1959年，世界卫生组织决定隔离天花病人，并给所有感染天花地区的居民接种，以此来彻底消除天花病毒。1980年，世界卫生组织宣布计划成功，天花已不复存在。
审校：Fiona 编辑：listen 来源：前十网
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