背景知识

　　《人性的枷锁》是一部自转体小说，是英国20世纪著名的小说家毛姆的主要作品之一。主人公菲利普生活屡受挫折，觉得人生似乎没有意义。最后在行医中，他体验到，一个人一旦能自觉地为人类做一点有益的事，人生也就变得有意义了，这样他才得以从枷锁下解脱出来。本篇描写菲利普在伦敦圣路加医学院门诊部实习期间的所见所闻。医生和病人的神态写得独具个性，从中我们可以体会到作者对生活深切而独到的观察和感受。

　　William Somerset Maugham

　　At the beginner of the winter session Philip became an outpatient's clerk. There were three assistant-physicians who took outpatients, two days a week each, and Philip put his name down for Dr. Tyrell. He was popular with the students, and there was some competition to be his clerk. Dr. Tyrell was a tall, thin man of thirty-five, with a very small head, red hair cut short, and prominent blue eyes: his face was bright scarlet. He talked well in a pleasant voice, was fond of a little joke, and treated the world lightly. He was a successful man, with a large consulting practice and a knighthood in prospect. From commerce with students and poor people he had the patronizing air, and from dealing always with the sick he had the healthy man's jovial condescension, which some consultants achieve as the professional manner. He made the patient feel like a boy confronted by a jolly schoolmaster; his illness was an absurd piece of naughtiness which amused rather than irritated.

　　The student was supposed to attend in the outpatients' room every day, see cases, and pick up what information he could; but on the days on which he clerked his duties were a little more definite. At that time the outpatients' department at St. Luke's consisted of three rooms, leading into one another, and a large, dark waiting-room with massive pillars of masonry and long benches. Here the patients waited after having been given their “letters” at mid-day; and the long rows of them, bottles and gallipots in hand, some tattered and dirty, others decent enough, sitting in the dimness, men and women of all ages, children, gave on an impression which was weird and horrible. They suggested the grim drawings of Daumier. All the rooms were painted alike, in salmoncolour with a high dado of maroon; and there was in them an odour of disinfectants, mingling as the afternoon wore on with the crude stench of humanity. The first room was the largest and in the middle of it were a table and an office chair for the physician; on each side of this were two smaller tables, a little lower: at one of these sat the house-physician and at the other the clerk who took the “book” for the day. This was a large volume in which were written down the name, age, sex, profession, of the patient and the diagnosis of his disease.

　　At half-past one the house-physician came in, rang the bell, and told the porter to send in the old patients. There were always a good many of these, and it was necessary to get through as many of them as possible before Dr. Tyrell came at two… The patients streamed in. The men came first. Chronic bronchitis, “a nasty aching cough” was what they chiefly suffered from; one went to the H.P. and the other to the clerk, handing in their letters: if they were going on well the words Rep 14 were written on them, and they went to the dispensary with their bottles or gallipots in order to have medicine given them for fourteen days more. Some old stagers held back so that they might be seen by the physician himself, but they seldom succeeded in this; and only three or four, whose condition seemed to demand his attention, were kept.

　　…

　　Dr. Tyrell gave each of his clerks a case to examine. The clerk took the patient into one of the inner rooms; they were smaller, and each had a couch in it covered with black horsehair: he asked his patient a variety of questions, examined his lungs, his heart, and his liver, made notes of fact on the hospital letters, formed in his own mind some idea of the diagnosis, and then waited for Dr. Tyrell to come in. This he did, followed by a small crowd of students… If there was anything interesting to hear students applied their stethoscopes: you would see a man with two or three to the chest, and two perhaps to his back, while others waited impatiently to listen. The patient stood among them a little embarrassed, but not altogether displeased to find himself the center of attention; he listened confusedly while Dr. Tyrell discoursed glibly on the case. Two or three students listened again to recognize the murmur or the crepitation which the physician described, and then the man was told to put on his clothes.

　　When the various cases had been examined Dr. Tyrell went back into the large room and sat down again at his desk. He asked any student who happened to be standing near him what he would prescribe for a patient he had just seen. The student mentioned one or two drugs.

　　“Would you?” said Dr. Tyrell. “Well, that's original at all events. I don't think we'll be rash.”

　　This always made the students laugh, and with a twinkle of amusement at his own bright humour the physician prescribed some other drug than that which the student had suggested. When there were two cases of exactly the same sort and the student proposed the treatment which the physician had ordered for the first, Dr. Tyrell exercised considerable ingenuity in thinking of something else. Sometimes, knowing that in the dispensary they were worked off their legs and preferred to give the medicines which they had all ready, the good hospital mixtures which had been found by the experience of years to answer their purpose so well, he amused himself by writing an elaborate prescription.

　　参考译文：

　　《人性的枷锁》节选(1)

　　威廉·萨姆塞特·毛姆

　　冬季学期一开始，菲利普就当上了门诊医生的助手。门诊部有三个助理医生给病人看病，每人一星期负责两天，菲利普报名跟帝勒尔大夫。帝勒尔大夫在学生们中名声很好，要给他当助手还要一番竞争才行。帝勒尔大夫瘦高个儿，35岁，脑袋很小，红色的头发，剪得很短，眼睛又蓝又突出，红光满面。他很善言谈，声音悦耳，喜欢开些小玩笑，待人豁达开朗。他很成功，求疹的病人络绎不绝，而且他还有希望得到爵士封号。由于跟学生、穷人打交道，所以他有着一副居高临下的样子;由于总是与病人接触所以他又带着健康人的快乐和优越感去关心病人，这种派头是某些专家、顾问养成的职业风度。他使病人觉得自己是站在快乐的校长面前的学生，而疾病不过是件荒唐的淘气行为，只让人觉得有趣而不必为之烦恼。

　　学生每天都得到门诊部去，看病例，尽可能地搜集信息，可是在执行助手职务的时候，他的责任是比较明确的。那时圣鲁克医院的门诊部有三间互相连通的疹室，还有一大间有大石柱和长条凳的阴暗的候诊室。中午时分，患者拿到教会发给贫民免费就疹的介绍信后便在这儿候诊。他们排成好几条长队，手里拿着瓶子和药罐，有的衣衫褴褛、脏兮兮的，有的还算体面，都坐在阴暗中，男女老少都有，给人一种古怪而恐怖的印象。他们让人想起多米埃的那些冷若冰霜的画像。门诊部的房间都被漆成一模一样，肉色墙壁，高高的栗色墙裙。房间里散发着消毒水的气味。随着下午慢慢过去，期间还混杂着人身上的臭味。第一个房间最大，房间中央摆着一张桌子和一把门诊医生的椅子;桌子两侧各有一张稍微小一些也低一些的桌子，一张桌子旁坐着住院部医生，另一张桌子旁坐着登记当天病例簿的助手。病例簿有厚厚一大本，上面写着患者的姓名、年龄、性别、职业和病情诊断。

　　住院部医生一点半来，他进来后就打铃告诉勤杂工把那些老病号叫进来。这种病人总是相当多，在两点钟帝勒尔医生到来之前，必须尽量把这些病人看完。......病人们络绎不绝地进来，先进来的是男病人，他们大多数都患慢性支气管炎，猛烈干咳，咳得想吐。住院部内科医生和助手每人分别看一个病人，病人将就疹介绍信交上来。如果他们的病有所好转，就在他们的介绍信上记上“重复14天”这几个字，然后他们再拿着瓶子和药罐到药房去取够半个月服用的药。有些老病号老往后退，以便能轮到医生给他们看病，不过他们很少能如愿，只有三四个病情够得上请医生看的病人可以留下来让医生诊断。

　　......

　　帝勒尔大夫给他的助手一人一个病人让他们去诊察。助手把患者带进里边的一间屋子。里面的两间屋子都要小些。每间屋子里各有一张大沙发椅，上面盖着黑色马鬃。助手向患者提出各种问题，给患者检查肺、心、肝，在病历上作记录，脑子里想好自己的诊断意见，等着帝勒尔大夫进来。帝勒尔大夫进来了，身后簇拥着一小伙儿学生。......如果发现了什么地方需要听一听，学生们的听诊器就派上了用场。你会看到两三个学生围着一个男病人听胸部，另外两个在听背部，其余的则不耐烦地等着轮到他们去听。那病人有点狼狈地站在中间，不过，看到自己成了注意的中心，也没有什么特别不高兴的。当帝勒尔医生滔滔不绝地讲述着病例的时候，病人在一旁听得稀里糊涂。有两三个学生为了辨听出医生所描述的那种心肺杂音和肺部水泡音就又过来听一遍，然后才叫那个人把衣服穿上。

　　当各种病人都检查完了之后，帝勒尔大夫回到大房间在自己的桌前坐下。他随便问一个站在他身边的学生，应该给刚才检查过的病人开什么药方，这个学生提出一两种药来。

　　“就这么开吗?”帝勒尔医生说，“嘿，不管怎么说这方子可够有独到性啊!我认为我们不敢冒失。”

　　这话总要逗得学生们大笑，医生一边为自己机智的幽默得意地眨着眼睛，一边开出另外的某种不同于那个学生提出的药来。当有两个病人患的是一模一样的病时，那个学生就照医生给前一个病人开动处方治疗时，帝勒尔大夫就偏要花样翻新地用他想出来的另外一种处方。他知道那些药房的人会被医生支得跑来跑去，宁愿用那些早已准备好了的药——那些根据医院经验证明非常有疗效的自配药剂，所以有时为了开心，他就开出个刁钻古怪的药方来。

　　bondage 束缚

　　prominent 突出的，杰出的

　　condescension 屈尊，俯就

　　gallipots 药罐

　　tattered 破烂的

　　odour 气味

　　disinfectants 消毒水

　　mingling 混合

　　stench 恶臭

　　bronchitis 慢性支气管炎

　　dispensary 药房

　　stethoscopes 听诊器 

　　来源：加成培训