Exercise 53. Study What Tools a Doctor Carries to Work.

To the right is an example of the TOOLS CARRIED BY an "average doctor": 1 = a pressure cuff for taking blood, 2 = a stethoscope for listening to body sounds, 3 = a calculator for adjusting drug doses, 4 = a tape measure, 5 = a personal organizer/pda, 6 = an otoscope to look in ears, 7 = an ophthalmoscope to examine eyes, 8 = a light, 9 = a patella hammer for checking reflexes, 10 = a name tag and pen of choice - 'cause we write a lot!

It's important to remember that specialists will carry different tools to work and some doctors don't even use stethoscopes - for example a dermatologist doesn't need to listen to your skin. And other instruments are so big, like ultrasounds, they're left at work. And of course, the most important tool a doctor must carry to work each day is their brain :)

Exercise 54. Read the text “How a Doctor Visit Works”. Make up five types of questions to it.

How a Doctor Visit Works

When something goes wrong with your body you VISIT A DOCTOR to get it working right again!

The first thing your doctor will do when you sit in front of him or her is ask you questions. This is because they need to narrow their search down to what two or three problems you most likely have.

A good interview alone can lead a clinician to a correct guess diagnosis most of the time.

This is because diseases tend to have unique signatures, i.e. their symptoms repeat again and again like fingerprints in persons they strike.

Once your doctor has an idea what might be your problem they then look for proof. This is done by examining you, looking for physical evidence, and through tests related to your complaints.

With all this information together, your doctor then makes a logical calculation of your diagnosis like this:

Symptoms + PHYSICAL FINDINGS + Test Results = Diagnosis

Of these three inputs, physical findings are regarded highest, i.e. if a doctor listens to your chest and hears fluid in it, s/he will treat you for this even if your chest x-ray looks normal and blood tests says that your oxygen level is fine.

After diagnosis your doctor then provides a standardized treatment /prescription for your ailment. These treatments are developed by university hospitals and large clinical trials which compare treatments for effectiveness. The best results from these studies are then printed and circulated as treatment recommendations to physicians.

Diagnosis is very important to doctors because it is the language that doctors think in. A diagnosis X is a name for a disease which has X symptoms, X physical findings, and X test results. The beauty of a diagnosis label is that another doctor seeing you for the first time immediately knows what symptoms you probably have, what to expect physically, and what your treatment should be.

The last step after treatment is follow-up. This means a repeat visit to your doctor where s/he checks that you are back to normal. Chronic illnesses like diabetes and high blood pressure where the problem never goes away, need long-term follow-up every couple of months to monitor that the disease is staying under control and not getting worse.

Exercise 55. On the left there are examples of twelve useful verbs in medicine, on the right there are definitions of the verbs. Read the examples and match the verbs (in italics) with the definitions. Then write the infinitive forms into the spaces in the definitions on the right. The first one has been done for you as an example.

EXAMPLES

DEFINITIONS

After the accident the passengers were treated in hospital for cuts. He depends on drugs to relieve the pain. He specializes in children with breathing problems. She suffers from headaches. She was vaccinated against smallpox as a child. Some forms of cancer still cannot be cured. The calamine lotion will soothe the pain. The doctor diagnosed appendicitis. The doctor prescribed a course of antibiotics. The drug suppresses the body's natural instinct to reject the transplanted tissue. The operation may endanger the life of the patient. The surgeons decided to operate as the only way of saving the baby's life.

diagnose means to identify a patient’s condition. means to look after a sick or injured person. means to make a patient healthy. means to put at risk. means to give instructions for a patient to get a certain dosage of a drug. means to study or treat one particular disease or one particular type of patient. means to have an illness for a long time. means to treat a patient by cutting open the body and removing, replacing or repairing a part. means to give a person immunization against a specific disease. means to relieve pain. means to rely on or need something. means to remove a symptom.

Exercise 56. Which item in the list of instruments and equipment does each one refer to? The first one has been done for you as an example.

LIST OF INSTRUMENTS AND EQUIPMENT

bandage; catheter; curette; drain; forceps; gag; hook; pipette; probe; scalpel; sling; splint; stethoscope; stretcher; syringe; thermometer; tourniquet; wheelchair

1. A chair with wheels in which an invalid can sit and move around is a wheelchair.

2. A small, sharp pointed knife used in surgery.

3. An instrument used to explore inside a cavity or wound.

4. An instrument similar to a pair of scissors, used for holding and pulling.

5. A long spoon, used for scraping the inside of an organ.

6. A thin glass tube used for taking and measuring samples of liquids.

7. A device used to constrict an artery and reduce the flow of blood.

8. An instrument with a bent end, used for holding structures apart.

9. A tube used to remove liquid from the body or the site of an operation.

10. An instrument which is placed between a patient's teeth to stop him closing his mouth.

11. A tube with a plunger which slides inside it, forcing the contents out through a needle.

12. A tube which is passed into the body along one of the passages.

13. A piece of cloth which is wrapped wound a wound or injured limb.

14. A triangular piece of cloth attached around the neck, used to support a broken arm.

15. A folding bed, with handles, on which an injured person can be carried by two people.

16. A stiff support attached to a limb to prevent a broken bone from moving two earpieces connected to a tube and a metal disc, used to listen to sounds inside the body.

17. A device used for measuring temperature.

Extension. Work with a partner and test each other. For example: What do you call a chair with wheels in which an invalid can sit and move around

Exercise 57. Fill in the gaps with the correct words from the box.

immune system itchy lab ICU immunized life support inflamed incision IV injuries lab results inconclusive internal infant infected

1. Her ___ were minor; just a few cuts and bruises.

2. Babies are ___ three times in their first year.

3. I had to have stitches to close the___.

4. The woman has severe brain damage and is currently on___.

5. My right ankle was so ___ it was twice the size of my left one.

6. She will remain in the ___ until she can breathe on her own.

7. The doctors will be monitoring her for any ___ bleeding.

8. If you are allergic to this medication your skin will get red and___.

9. The toddler was so dehydrated that the doctor decided to get him on an___.

10. The ___ have come in and you are free to go home.

11. I'll take these samples down to the ___ on my way out.

12. We have to do more x-rays because the first ones were___.

13. The nurse will demonstrate how to bathe an___.

14. You can't have visitors because your ___ is low.

15. The wound should be covered when you swim to prevent it from becoming___.

LISTENING AND SPEAKING

Exercise 58. Nowadays a lot of people prefer alternative medicine (different from typical western systems). For example:

acupuncture, chiropractic, herbal medicine, homeopathy, and aromatherapy. What do we call the type of alternative medicine which …

1. uses herbs and other natural plants?

2. uses oils which smell nice and are rubbed into your body?

3. uses needles to stick into specific parts of your body?

4. uses tiny amounts of substances which cause the illness the doctor is trying to cure?

5. manipulates your spine and bones to ease backache and other pains?

Have you ever tried any of the medicine described above?

If YES, was it helpful/painful/expensive?

Why did you decide to try it?

Exercise 59. 1. LISTEN to the radio programme about holistic medicine and complete the chart with some of the differences between Western and holistic medicine.

Western medicine	Holistic medicine

2. What are the three stories discussed on the programme? What were the patients suffering from?

3. What is the system that Glenna Gullingham is trying to set up?

4. Why, in her opinion, is holistic medicine becoming more popular?

Exercise 60. What do YOU think?

Do you agree with Miss Gullingham that we are becoming more health conscious? Have your attitudes to health care changed at all?

WRITING

Exercise 61. Write your friend a letter describing your last visit to the doctor. Mention

• your complaints,

• the appointment,

• the doctor’s diagnosis and

• recommendations.

PART V. HEALTH CARE SYSTEMS

Exercise 62. Read and translate the text.

The National Health Service (NHS) The NHS is in charge of health care in the UK. Originally it consisted of one national organisation, which covered the whole of the country, but more recently, it has been decentralised into four independent organisations; one for each of the countries, which make up the United Kingdom. Each service has its own legislation, but each service will treat the needs of citizens from other parts of the UK.

Care trusts in charge of treatment policies, vaccination programmes and healthcare budgets run the NHS service.

The NHS is a free service to all residents of the UK, including members of the armed forces who are working abroad. British citizens who reside outside of the UK are subject to charges regardless of whether they have paid National Insurance contributions. The service is financed from mandatory national insurance taxation paid by employees directly from their salaries and supplemented by an obligatory contribution from employers. Self-employed persons have to pay the full contribution themselves. The onus is on the employer to deduct contributions from the employee’s wages. Dependant family members and vulnerable groups like the unemployed are exempt from contributions.

Private health care The UK has a relatively strong private healthcare sector, which is funded largely by private insurance contributions, but it is used only by a limited percentage of people, often as a top-up to the basic state healthcare.

Private hospitals are owned by private companies. Contributions to private funds vary from person to person and are dependant on age, general health, and the existence of previously diagnosed diseases and the level of care required by each subscriber. Many companies offer their employees and their dependants’ private health insurance as a benefit of the job. BUPA and Nuffield Hospitals are the leading private hospital operators in the UK.

There are many incidences when private patients will be treated in an NHS hospital because the private hospital lacks the specialist equipment. In these cases, the private patient is given their own room and is treated before NHS patients. Emergency patients supersede all patients both private and NHS.

General Practitioners (GPs) General practitioners provide basic general healthcare and are the first point of contact with the UK health system. GPs operate in practices, which consist of several other practitioners. They employ clerical staff to handle the daily running of the practice and nurses to deal with routine vaccination, health education, preventative care and maternity. Citizens are free to register with the GP of their choice. If you need to consult a doctor, you have to make an appointment at his practice or if you need urgent attention, you can call him to your home, attend the surgery on a speculative basis or visit your nearest emergency department.   GPs prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education. Some GPs also care for hospitalised patients, conduct minor surgery and obstetrics.

Consultants Consultants are senior doctors who have completed a higher level of specialised training. GP's refer patients to a Consultant if he believes that a patient may need specialist help and diagnosis. There are numerous specialist fields of medicine in the UK like gynaecology, oncology, paediatrics and dermatology. There is often a waiting list to see Consultant doctors.

Dispensing and Prescription Charges Only doctors and consultants can prescribe medicine in the UK. Prescription medicine is only available from a qualified and registered chemist or from a hospital pharmacy. There is, however, a wide choice of over-the-counter drugs, which can be purchased in many retail outlets including supermarkets. Drugs like painkillers and cold remedies are available over-the-counter and do not require a prescription or consultation with a doctor.

All working adults must pay prescription charges of £6.85 for any medicine prescribed by a doctor. Children under 16 or 18 if they are in full time education, the over 60's, pregnant women, patients with certain medical conditions, low income earners or those receiving state benefits are exempt from any prescription charges.

Citizens who find they need a repeated course of medicine, but do not fall into one of the exempt categories are entitled to use single-charge pre-payment certificate which allows an unrestricted number of prescriptions during the period for which it is valid.

Prescription charges are the same regardless of the actual cost of the medicine needed, but higher charges apply to medical appliances.

Dentistry Most dentistry in the UK is now private although some dentists still work for the NHS. Dental practices only take a limited number of NHS patients. People who are exempt from paying prescription charges (except those with certain medical conditions) are exempt from dental charges too. Many dentists have waiting lists of NHS patients wishing to register with their practice. If you are not enrolled into a practice, you will not receive treatment unless you are a private patient. Fees are paid directly to the dental practice once a series of treatment is complete.

Opticians Eye care in the UK is private but a limited amount of care is available on the NHS. This tends to be confined to people exempt from prescription charges and generally only covers a free eye test and where necessary the provision of a pair of glasses, which can be chosen from a limited selection of designs. All other optical work is private and fees are paid at the time of consultation, directly to the optical practice.

Accident and Emergency (A&E) A&E departments (sometimes referred to as Casualty) provide emergency treatment to patients with a wide range of illness and injury, some of which may be life threatening and requiring immediate attention. Citizens do not pay to for treatment or use of the A&E service.

A&E departments are open nonstop all year round. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available.

Upon arrival at A&E, a nurse assesses the nature and seriousness of your condition. Individuals with serious illnesses are seen immediately by a doctor. Once the patient has been assessed and treated, they may be admitted to the hospital, transferred to a different hospital or discharged. Emergency departments are located in main hospitals and are staffed by hospital doctors and nurses with specialised training in emergency care, emergency medical technicians, radiology technicians, healthcare assistants and  voluntary staff who all work together to treat emergency patients and provide support to concerned family members.

NHS Direct England, Wales and Northern Ireland have a 24-hour private telephone service, online consultancy and an interactive digital TV health advice programme, which is provided by NHS Direct. Similar services exist in Scotland under the name NHS24. The service was designed to relieve waiting times at GP surgeries and to provide care out of surgery hours. It is staffed by trained nurses who provide guidance on which healthcare provider the caller should access and how to cope with a bout of sickness at home.

NHS Walk-In Centres There are over 80 NHS Walk-in Centres in the UK, but some do not treat children. NHS Walk-in Centres give you quick access to health information and medicine. They can be used by everyone and an appointment is not necessary. They are open every day from early morning to late evening, 365 days a year. Their aim is to provide fast access to health advice and treatment. They work in a similar manner to NHS Direct.

Exercise 63. Fill in the gaps with the necessary prepositions.

1. The NHS is in charge ___ healthcare ___ the UK.

2. The NHS is a free service ___ all residents ___ the UK, including members ___ the armed forces who are working abroad

3. The onus is ___ the employer to deduct contributions ___ the employee’s wages.

4. British citizens who reside outside ___ the UK are subject ___ charges regardless ___ whether they have paid National Insurance contributions.

5. Contributions to private funds vary ___ person ___ person and are dependant ___ age, general health, and the existence ___ previously diagnosed diseases and the level ___ care required ___ each subscriber.

6. Prescription medicine is only available ___ a qualified and registered chemist or ___ a hospital pharmacy.

7. Children ___ 16 or 18 if they are in full time education, the ___ 60's, pregnant women, patients with certain medical conditions, low income earners or those receiving state benefits are exempt ___ any prescription charges.

8. Upon arrival ___ A&E, a nurse assess the nature and seriousness ___ your condition.

9. Similar services exist in Scotland ___ the name NHS24.

10. NHS Walk-in Centres give you quick access ___ health information and medicine.

Exercise 64. Fill in the gaps with the missing words.

1. Private hospitals are owned by ___ ___.

2. General practitioners provide ___ ___ ___ and are the first point of contact with the UK health system.

3. GPs ___ drugs, ___ acute and chronic illnesses, and ___ preventive care and health education. Some GPs also ___ ___ hospitalised patients, ___ minor surgery and obstetrics.

4. ___ are senior doctors who have completed a higher level of specialised training.

5. Only doctors and consultants can ___ ___ in the UK.

6. Most dentistry in the UK is now ___although some dentists still work for the NHS.

7. A&E departments are open ___ all year round.

8. Individuals with ___ ___ are seen immediately by a doctor.

9. England, Wales and Northern Ireland have a 24-hour private ___ ___, online consultancy and an interactive digital TV health advice programme, which is ___ by NHS Direct.

10. There are over 80 NHS Walk-in Centres in the UK, but some do not treat ___. NHS Walk-in Centres give you ___ ___ to health information and medicine.

Exercise 65. Answer the questions.

1. What is the NHS?

2. How many organizations does it consist of?

3. What are care trusts in charge of?

4. The NHS is a free service to all residents of the UK, isn’t it?

5. How is the service financed?

6. What are the names of the leading private hospital operators in the UK?

7. What is the function of GPs?

8. What are consultants?

9. What kinds of drugs are available over-the-counter and do not require a prescription or consultation with a doctor?

10. What is the prescription charge for any medicine in the UK?

11. What categories of population of the UK are exempt from any prescription charges?

12. Dentistry in the UK is now all private, isn’t it?

13. What does free eye-care cover and who can be confined to it?

14. What is the function of A&E departments?

15. Why were the 24-hour private telephone service and NHS Walk-In Centres designed?

Exercise 66. Fill in the gaps with the words from the box.

pharmacy malignant operation pharmacist life-threatening medical school light-headed physician numb newborn paralyzed OR pain killers pain patients

1. The victim was shot in two places but the bullet wounds are not___.

2. If you are feeling ___ again, lie down and call me.

3. I'm afraid at least one of the tumours is___.

4. The needle will make your lower body feel___.

5. After eight years of ___ I can finally practice medicine.

6. You have to support her neck because she is still a____.

7. You must wear a face mask and gloves while you are in the___.

8. The ___ lasted seven hours, but it was successful.

9. You can take two ___ every four hours.

10. We gave your husband some medicine to relieve some of the___.

11. We thought her legs were ___ for life, but she is learning how to walk.

12. You should be able to buy a bandage at the___.

13. The ___ in Room 4 are not getting along.

14. Ask the ___ if there is a generic brand of this medication.

15. Ask your family___ to refer you to a specialist.

Exercise 67. Match the parts of the sentences.

The child was bitten by a … The woman was well prepared for labour … You will need to visit your doctor … You will have to pay for a private hospital room if … If the radiation doesn't kill all of the abnormal cells, ... John is a resident under … I'd like to see you a year from now… I have some extra scrubs in … I have to scrub up and … I went to another doctor to… People who suffer from epilepsy are prone to … The woman was in shock after … One of the side effects of antidepressants … I have a sore throat and … Ever since I injured my leg I've been having…

the cancer will come back. muscle spasms in my upper thigh. to get another prescription. for a routine check-up. poisonous snake. is a loss of appetite. get a second opinion about these headaches. because she took the prenatal classes. you don't want a room-mate. get ready for surgery. Dr Brown. being pulled from the river. a runny nose. my locker. seizures.

Exercise 68. Here are two jumbled hints for tooth ache and bee sting first remedies. Decide which sentences go with which treatment.

1. Rinse out your mouth with lukewarm salty water or antibacterial mouthwash like 'Listerine'.

2. Wet an aspirin tablet and then wipe it over the bee sting bump (if you're not allergic to aspirin). This acts as an anti inflammatory easing the swelling and pain.

3. Floss between the affected teeth to get out trapped food particles.

4. Baking soda or ammonia solution also reduce pain from a bee sting by changing the acidity of the sting site.

5. Ask your pharmacist for a pain killer like aspirin, ibuprofen etc.

6. Use a paste of meat tenderizer on the bump. This helps to 'digest' the chemicals in the bee sting that make it so painful.

7. Ask your pharmacist for an antihistamine and ibuprofen. These will stop the itch and swelling, and ease the pain, respectively.

8. Wrap some ice in a towel and apply it over the toothache to deaden the nerves.

tooth ache	bee sting

Exercise 69. Read and translate the text. Match the headings A – J to the paragraphs I – IX. There is one extra heading you will not need to use.

A. Fees B. Emergency Care C. Opticians D. Private Clinics E. Doctors and Health Centres

F. Pharmacies G. Dentists H. Hospitals I. Consultants J. The State System

Health care in Ukraine

The standard of healthcare in Ukraine is extremely neglected with a severe lack of medical facilities and medicines. Some of the medical staff are highly trained, but some have only completed half of the training required. The healthcare is in an extremely poor state. Healthcare in Ukraine is supposedly free and available to all citizens and registered long-term residents. Private healthcare is also available in the country. All employed citizens contribute to the healthcare system. The Government of Ukraine oversees the health service and all citizens are entitled by law to equal access to healthcare

I __________________________ Healthcare in Ukraine is funded almost entirely by general government revenues; this fund makes up 7.4 percent of the fund. 3.2 percent of the fund is made up by social insurance contributions from the wages of the employed and 3.3 percent is funded by private clinics and their private patients. Dependant family members are covered by the contributions paid by employed family members. The unemployed, old age pensioners and people on long-term sickness benefit or maternity leave have to pay healthcare contributions but not as much as an employed citizen. Foreigners immigrating to Ukraine without jobs must produce proof of private health insurance in order to obtain their residence permit.

If you are self-employed, you need to get additional insurance to cover members of your family and you must pay the full contribution to cover yourself.

The state fund covers most medical services including treatment by specialists, hospitalisation, prescriptions, pregnancy and childbirth and rehabilitation.

II __________________________

The state, in theory provides free healthcare for its citizens and long term residents who become ill; however this is a serious problem for many parts of the country. Doctors’ wages are extremely low and often ask for a fee. This makes healthcare difficult, as many citizens are on a low income.  

III __________________________

Doctors are known as a likar and are the first point of contact with the Ukrainian health system. Citizens can register with the doctor of their choice, however, people seeking state medical care must make sure that their doctor is contracted into the health scheme. If you are treated by a doctor whether or not the doctor is covered by the state you will have to pay a fee.

GPs prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education.

Waiting times to see doctors vary and it is advised that you make an appointment in advance. If you need urgent help, you may go to the doctors surgery on speculation, but be prepared for a long wait.

Health centres in Ukraine are in an extremely poor state. The medical facilities are of a poor standard compared to Western standards; the medical equipment and facilities are in short supply compared to the high demand. All services, including doctors and nurses cost a lot of money which makes health care in health centres not always a feasible option for the ordinary citizen. The doctors and nurses who work in the health centres are not always fully trained in the health system.  

IV ___________________________ Consultants are senior doctors who have completed a higher level of specialised training. GPs refer patients to a Consultant if he believes that a patient may need specialist help and diagnosis. There are very few consultants in Ukraine, which therefore makes a high waiting list to see the Consultant doctors. The consultants are no different to a doctor in terms of them still asking for a fee, normally higher than a normal doctor due to their higher level medical skills.

V _____________________________ Hospitals and clinics exist in all major towns and cities of Ukraine, but are nowhere near the standard which is required in Ukraine. Hospitals are dirty and the level of care in extremely low due to staff shortages. Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors. All hospital doctors require a fee which makes hospitalisation difficult for its citizens. Doctors and nurses are in short supply due to low wages which is resulting in doctors and nurses going abroad and offering their services. There may be a waiting list for some non-emergency treatments and services.

VI _____________________________ Emergency care is supposedly to be free for everyone including those without state health insurance. However, once your condition is stabilised the doctor will probably ask for a fee for their services due to the low wages that the state provides. Emergency departments are open non-stop all year. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available.

VII ____________________________ There are a few private practices in Ukraine which are provided by independent office-based doctors and specialists. The premises are funded largely by private insurance contributions, but it is used only by a small minority of people, often as a top up to the basic state healthcare and to cover them for the services deemed non-essential. The private hospitals are cleaner and the comfort factor is a lot higher than a state hospital, there are no waiting lists, but then there is a higher fee, which is not always a feasible option for the ordinary citizen. 

VIII ___________________________ Dental care in Ukraine is expensive and not very many citizens can afford the dental care that is necessary, all dentist services are private in Ukraine. Dentists are known as a zubnyy likar. Dentists can be found in major cities of Ukraine normally where the income of the citizens are of the amount where they can afford dental care.

IX _____________________________ Dispensing chemists known as an apteka sell medicines in Ukraine. Prescriptions known as prypysannia are generally not needed to buy medicines, which are normally tightly monitored in Western countries. There are many pharmacies throughout Ukraine and the cost of medicine from a pharmacy can be expensive as there is no monitoring of drug prices. Many pharmacies in the major cities are open 24 hours, so there is always access to pharmacy medicines. 

Exercise 70. Make up questions to the text covering its main points. Work in pairs. Ask your partner the questions and answer his.

Exercise 71. Read the text on the History of Medicine and choose the best option to fill in the gaps.

1.Medicine/Healthcare is the science or art of preventing and treating diseases. It was natural for man to develop the 2.practice/practise of medicine because it is natural for man to protect himself. 3.Skeletons/Skulls of men who lived before the time of written history seem to show that men tried to treat wounds and broken bones. What they thought about the disease and its treatment is not certain. Probably they thought that disease was the 4.result/cause of witchcraft. It was something they did not understand, and therefore it frightened them. The main treatment 5.for/of it was magic and superstition. These magicians and witch doctors were the 6.ancestors/descendents of modern physicians, surgeons, and psychiatrists.

The ancient 7.Egyptians'/Egyptian’s system of medicine made disease and its treatment more sensible. They were 8.good/bad observers and recorded what they saw. Medical schools were established and surgery, particularly eye surgery, was advanced. However, disease and its treatment were part of the ancient Egyptian 9.religion/revenge. Prayers, charms, and sacrifices to the gods were part of the treatment. The doctor was a doctor- 10.witch/priest.

Medicine in India, especially 11.dentistry/surgery, was highly developed. Plastic surgeons did certain operations 1000 years before other surgeons tried them. Here too, magic and religion were a part of medical practice.

Scientific medicine had its beginnings in Greece. Doctor-priests ran 12.churches/temples where the sick could be treated and nursed. In Greece these priests were called Asclepiads; that is servants of the god of 13.medicine/doctors, Asclepius.

The Romans called the god of medicine Aesculapius. Hippocrates (460 ?–?377 B.C.) is called the 14.son/father of medicine. His approach to 15.medicine/the medicine was scientific. He put aside all superstition, magic, and charms as having no part in understanding the cause and treatment of disease. He and his 16.relatives/pupils made careful records of their cases.

Some of their observations are considered to be true even today: e.g. Weariness without cause indicates disease. When sleep puts an end to delirium, it is a 17.good/bad sign. Hippocrates' moral idea of what a doctor should be has had a 18.slight/great influence on physicians ever since. It is as important as his scientific contributions.

Medical schools today have graduating students have the Hippocratic 19.Oath/Prayer. The best of Hippocratic medicine was continued in the great medical school of Alexandria, Egypt, which was 20.founded/found about 300 B.C. By dissecting human bodies Greek physicians learned a great deal about how the organs work and the diseases that affect them. They were greatly interested 21.in/about the nervous system and described the brain with fair accuracy.

With the 22.flourish/breakdown of the Roman Empire around A.D. 400 there was little encouragement of medicine in Europe. After the 8th century the Arabs spread their empire from Persia to Spain. Under them medical schools and hospitals flourished. Greek and Roman medical books were translated into Arabic. Ibn Sina (Avicenna) and Rhazes were two of the most famous Mohammedan physicians. Mohammedan physicians however were forbidden to perform autopsies. Thus they did not add to the knowledge of anatomy (structure of the body) and the effects of disease on the body.

A few centuries later a new desire to study and inquire into the nature of things gradually started in Europe. This is called the 23.Romanticism/Renaissance. By the 15th century this movement was at its height in Italy. Artists such as Leonardo da Vinci began to learn the structure of the human body. But it was not until the 18th century that medical knowledge was used widely to safeguard the health of people. Many hospitals were 24.built/closed, sanitation for cities and towns became more important. 25.The sewers/Sewers were covered and streets were paved and lighted.

The first «pulse watch» was introduced in 1707. Around this time thermometers were also tried out. The most important name among many excellent 18th century physicians was Edward Jenner, an Englishman, who successfully produced a vaccination 26.against/for smallpox. Experimental medicine and surgery 7.were/was greatly advanced by John Hunter, 28.an/the English surgeon and physiologist. It is said that he 29.took/had taken surgery away from the barbers and made it a scientific profession.

Modern medicine, as we know it now, 30.has begun/began in the 19th century. An important way of testing for diseases of the chest was developed by French physicians. They 31.found/founded that different parts of the body give their own sounds when thumped. The story is told that the French physician Rene Hyacinthe Laennec could not thump the chest and heart of a patient because her chest was too stout. She was young and so he hesitated to put his ear on her chest. He finally rolled a heavy piece of paper into a cylinder and put one end to the 32.patient's/patients’ chest and the other to his ear. The beat of the heart could be 33.clear/clearly heard. In this way a very important tool for diagnosis of diseases, 34.the/a stethoscope, was invented.

On March 30,1842, Crawford Williamson Long, a US physician, anesthetized a patient with 35.gin/ether. Painless operations were possible from that time on. This event was the beginning of modern surgery.

A Scottish surgeon, Joseph Lister tried to prevent 36.bacteria/bacterium from entering a wound by boiling instruments and using antiseptic solutions. Modern aseptic (germ-free) surgery grew out of his work. In the early 20th century, Wilhelm Roentgen 37.successfully/successful developed X-ray pictures for medical use.

The history of antibiotics began in 1928 with Sir Alexander Fleming, an English bacteriologist, who noticed that bacteria did not 38.grew/grow around the Penicillium mold. In 1939 Howard Florey and Ernst Chain, English scientists, had 39.studied/studied the observations of Fleming and developed penicillin, the most widely 40.used/using antibiotic.

SPEAKING

Exercise 72. Discuss the following quotations.

1. A sad soul can kill you quicker than a germ. John Steinbeck

2. The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not. Mark Twain

3. He who has health has hope; and he who has hope has everything. Arabian Proverb

4. Our mental and emotional diets determine our overall energy levels, health and well-being more than we realize. Every thought and feeling, no matter how big or small, impacts our inner energy reserves.

5. "If taking vitamins doesn't keep you healthy enough, try more laughter:" Nicolas-Sebastien Chamfort

6. "A good laugh and a long sleep are the best cures in the doctor's book." Irish Proverb

7. "Health is worth more than learning." Thomas Jefferson

8. "Health is not valued till sickness comes."

9. There’re lots of people in this world who spend so much time watching their health that they haven't the time to enjoy it.  Josh Billings

10. The greatest wealth is health.  Virgil

11. Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.  World Health Organization, 1948

12. Eat right, exercise regularly, die anyway.  Author Unknown

13. When it comes to eating right and exercising, there is no "I'll start tomorrow."  Tomorrow is disease. 

14. My own prescription for health is less paperwork and more running barefoot through the grass.

15. If man thinks about his physical or moral state he usually discovers that he is ill.  Johann Wolfgang von Goethe

16. The part can never be well unless the whole is well.  Plato

17. Doctors are always working to preserve our health and cooks to destroy it, but the latter are the more often successful. Denis Diderot

18. Nothing is more fatal to Health, than an over Care of it.  Benjamin Franklin

WRITING

Exercise 73. Imagine you are an exchange student in the UK now. Your counterpart from the UK has fallen ill while staying in Ukraine. You, being in the UK, have to write him an e-mail letter explaining the differences between health care systems of Ukraine and the UK.

ADDITIONAL EXERCISES

Exercise 74.Match the parts of the body with the definitions

1. kidney	a. organ in the head which controls thought and feeling
2. lung	b. long pipe leading from the stomach which takes waste
3. liver	c. two small, fleshy organs in the throat
4. heart	d. baglike organ in which food is broken down for use of the body
5. brain	e. one of 24 bones protecting the chest
6. intestine	f. one of a pair of organs which separate waste liquid from the blood
7. appendix	g. one of two bony parts of the face in which teeth are set
8. tonsils	h. large organ which clears the blood
9. rib	i. one of a pair of breathing organs in the chest
10. stomach	j. passage from the back of the mouth down inside the neck
11. jaw	k. short organ in the chest which controls the flow of blood by
12. throat	organ in the chest which controls the flow of blood by pushing it round the body

Exercise 75. Choose the correct answer.

1. The doctor asked me to …………. to the waist.

a. bare b. strip c. take off d. undress

2. The nurse put a ....... round Jane's bleeding knee.

a. bandage b. belt c. ribbon d. scarf

3. He had injured his arm badly and had to keep it in a ……… for several weeks.

a. cradle b. litter c. sling d. stretcher

4. The doctor told her that her temperature was ……….. .

a. current b. familiar с. habitual d. normal

5. Although the patient's condition is serious, she seems to be out of a ………… .

a. bedstead b. cot c. couch d. stretcher

6. My sister works in a house for the deaf and ....... .

a. dumb b. mute c. speechless d. voiceless

7. Make sure you ....... your food properly before you swallow it.

a. bite b. chew c. crunch d. eat

8. The doctor took his temperature and felt his ....... .

a, blood b. muscle с. pulse d. vein

9. The man who was taken to hospital had been ....... for three hours.

a. indifferent b. insensitive c. unconscious d. unfeeling

10. The injured man was taken to hospital on a(n) ....... .

a. ambulance b. bed c. sling d. stretcher

Exercise 76. Fill in the blanks with the words below.

bacteria body break dangerous delicate disease eyes germs line skin liquids membrane moisture mouth nose parts prick sneeze stomach

HOW THE BODY FIGHTS DISEASE

The 1 ....... is often called "the body's first 2 ....... of defence." It acts as armour, resisting many germs that might harm the more 3 ....... parts of the 4 ....... . Any 5 ....... in the skin, even a pin 6 ....... , provides an opening for 7 ....... germs. Some 8 ....... enter the body through the 9 ....... and 10 ....... and other natural openings. These areas provide warmth and 11 ....... , in which germs thrive. When the 12 ....... of the nose and throat becomes irritated, we cough or 13 ....... , blowing out the unwanted substances.

Other body 14 ....... also provide a defence against 15 ....... . Tears, for example, wash 16 ....... from the 17 ....... . Tears also contain substances that fight bacteria. Acid in the 18 ....... kills many germs before they can reach other 19 ....... of the body.

Exercise 77. Match the questions and the answers.

1. Why are you sneezing? 2. Why are you crying? 3. Why are you yawing? 4. Why are you coughing? 5. Why are you bleeding? 6. Why are you sweating? 7. Why are you shivering? 8. Why are you shaking? 9. Why are you vomiting?

a. I'm terrified by this story. b. I've cut myself with a bread-knife. c. I'm bored with the lecture. d. Cigarette smoke irritates my throat. e. You are hurting me. f. I have a bad cold. g. I'm very cold. h. I must have eaten some bad food. i. It's too warm in here.

Exercise 78. Match the problem and the piece of advice.

1. I keep getting the headaches. 2. I can't get into my clothes. 3. I can't sleep at night. 4. My eyes are often sore and I sneeze a lot. 5. I'm going to Kenya on business. 6. I've got a bad stomach. 7. I feel much better now, doctor. 8. I've got a terrible cough.

a. ....... Good, you needn't come back for a month. b. ....... You really must stop smoking. с. …… Perhaps you should have an eye test. d. ....... You ought to do more exercises. It's very relaxing. e. ....... You'll have to have a few injections. f. ....... You shouldn't eat so much fried food. g. ....... You really must lose some weight. h. ….. You should have some allergy tests.

Exercise 79. Match the two parts of the sentences.

1. I feel much healthier since ... 2. Both women played well and ... 3. I'm so unfit, ... 4. Citrus fruits such as oranges and lemons ... 5. Brown bread is ... 6. The discovery of penicillin ... 7. Doctors are trying out ... 8. My mother's having an operation tomorrow - ... 9. Before undergoing surgery, ... 10. The side effects of this drug may ... 11. He was examined by the doctors, ... 12. We had to take Bob to casualty after ...

a. ... she's having her appendix removed. b. ... revolutionised Western medicine. c. ... he fell downstairs. d. ... a new treatment for depression. e. ... looked in good shape. f. ... include fever and dizziness. g. ... but none of them could find anything physically wrong. h. ... more nutritious than white. i. ... I can't even run to the top of the stairs. j. ... patients can discuss their operation with a doctor. k. ... I stopped smoking. 1. ... are very good for you.

Exercise 80. Complete the sentences below with a preposition.

My wife complained that something was wrong … her. She said she had a pain … her back and that she suffered … bad headaches. As she was getting worse and worse I sent … a doctor. Immediately afterwards she was taken … hospital. Yesterday she was operated … . Now she feels much better.

Exercise 81. Your friend has a few marks on his body. Match the name of the mark with the explanation of its origin.

This bite on my leg These blisters on my feet This bruise on my eyelid This cut on my thumb This graze on my knee This scar on my belly this scratch on my arm These spots on my cheeks This sting on my chin

I got when I was operated on for appendicitis. I got when I went on a walking tour in too tight shoes. I got when I was hit by my friend during our quarrel. I got when I fell down while running. I got when I suffered from measles. I got when I was cutting onions with a sharp knife. I got when I was attacked by a fierce dog. I got when I was playing with my cat. I got when I went to take some honey from the beehive.

Exercise 82. Match the following symptoms of disease with their definitions.

belching colic constipation cramp diarrhea dizziness faint fatigue fever heartburn hiccups indigestion inflammation insomnia itch jaundice nausea neuralgia pus rash

difficult or infrequent emptying of the bowels weariness from bodily or mental exertion to become senseless and motionless feeling as if everything were turning round act of sending out gas from the stomach noisily through the mouth a burning sensation in the stomach from indigestion pain in a nerve feeling of sickness as caused by bad food yellowness of the skin and the whites of the eyes inability to sleep a sensation in the skin causing a desire to scratch the soft yellowish substance formed in and coming out from a poisoned place in the body patch of tiny red spots on the skin severe pain in the stomach and bowels too frequent and too watery emptying of the bowels sudden and painful tightening of the muscles condition of the body with temperature higher than usual a spasm of the respiratory muscles a redness and swelling attended with heat, pain difficulty in digesting food