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  3. Disease is a fluid concept influenced by societal and cultural attitudes that change diachronically in response to new sc

Disease is a fluid concept influenced by societal and cultural attitudes that change diachronically in response to new sc

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问题              Disease is a fluid concept influenced by societal and cultural attitudes that
       change diachronically in response to new scientific and medical discoveries.
       Historically, doctors defined a disease according to a cluster of symptoms, and
Line    as their clinical descriptions became more sophisticated, they started to classify
(5)     diseases into separate groups, so that from this medical taxonomy came new
       insights into disease etiology. Before the 20th century, schizophrenia and
       syphilitic insanity were treated as the same disease, but by early 1900 it became
       evident that psychoses without associated dementia represented a separate
       disease for which the term schizophrenia was then coined. The definition of
(10)    schizophrenia continues to evolve from the psychiatric disease of the 1960s to an
       illness with a suspected genetic etiology, though the existence of such an
       etiology remains uncertain. While an optimistic hunt is still on for the genes
       involved, we must continue to define schizophrenia in terms of the presence or
       absence of "positive" and "negative" symptoms.
(15)         Labeling someone as diseased, however, has enormous individual, social,
       financial, and physical implications, for irrespective of disease symptoms, the
       label itself may lead to significant distress. Individuals with asymptomatic
       conditions, including genetic variations, may be perceived by themselves or
       others as having a disease. It is not that labeling someone as diseased is always
(20)    positive-it does have severe ramifications, affecting decisions to have children
       or resulting in unjust treatment by life, medical, and disability insurers-but it
       can be beneficial, legitimizing symptoms, clarifying issues of personal
       responsibility, and improving accessibility to health care.  Nevertheless,
       deviations from normal that are not associated with risk should not be
(25)    considered synonymous with disease. Two schools—nominalist and essentialist
       or reductionist—have debated the clinical criteria used to label a patient as
       diseased. Nominalists label symptoms with a disease name, such as
       schizophrenia, and do not offer an explanation of the underlying etiology, while
       essentialists contend that for every disease there is an underlying pathological
(30)    etiology, and now argue that the essential lesion defining the disease state is a
       genetic abnormality.
           It has been suggested that diseases defined according to the essentialist
       tradition may be precisely wrong, whereas those defined in the nominalist
       traditional may be roughly accurate. But in labeling a disease state, we must
(35)    consider both  the  phenotype  (symptoms)  or  the  genotype  (genetic
       abnormality), for the former describes a state that places individuals at some
       definable risk of adverse consequences, while the latter helps suggest specific
       genetic or pharmacologic therapies. Thus, both clinical criteria and genetic
       abnormalities should be used to define a disease state, and the choice of a
(40)    disease definition will vary according to what one wishes to achieve, the genetic
       counseling of family members or the effective treatment of the patient.
It can be inferred that which of the following situations is likely to be most problematic to an adherent of the "essentialist" method of pathological taxonomy?
选项 A、A patient suffering from fever, in which the virus that is apparently responsible for the symptoms has not been isolated
B、A patient suffering from lung inflammation which, though resembling other inflammations, does not respond to any known treatments
C、A patient suffering from a genetic anomaly whose cause may be known but whose consequences remain unidentified
D、A patient infected with a variety of bacteria that is known to cause two diseases with dissimilar symptoms
E、A case of a patient with symptoms that may have arisen from two known diseases of different sources
答案A
解析
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