来源：大英百科在线（Britannica）

作者：Kara Rogers

译者：80

编校：伏维阁主

原文链接：http://www.britannica.com/list/13/9-diagnoses-by-charles-dickens

英国小说家查尔斯·狄更斯可谓描写疾病症状的佼佼者。他善于运用委婉的修辞和语言来描写疾病。从医学角度解读他的作品，诊断角色，几乎成了历史学家和医生的习惯。在某些情况下，狄更斯的描写甚至超前于医生的诊断——这更证明了他高超的洞察力。我们即将为您介绍狄更斯笔下的9个角色，以及狄更斯对他们病症的描述。

9. 《圣诞颂歌》中的埃比尼泽：真菌中毒

在《圣诞颂歌》中的圣诞前夜，吝啬鬼埃比尼泽（Ebenezer Scrooge）重返过去，在幻觉中看到了现在和未来。第二天，回到50多岁的埃比尼泽变得异常大方快乐。在他看到幻觉的那夜，埃比尼泽曾抱怨说自己消化不好。一些人认为这是麦角菌中毒的证据；而麦角曾一度是黑麦面包的常见污染物（译者注：设置在狄更斯时期的BBC电视剧《开膛街》第一季第三集的案子，就是混入麦角的黑麦面包引发的麦角菌中毒事件）。另一些人则认为埃比尼泽可能中风了，或者患了失智症或暂时性的精神错乱。

8. 《圣诞颂歌》中的小蒂姆：维生素D缺乏症

不管《圣诞颂歌》中埃比尼泽的幻觉是什么造成的，它都救了小蒂姆（Tiny Tim）的命。埃比尼泽在幻觉中受到警告：“如果黑暗不散，小蒂姆坐的地方将会只剩下一把空椅。”狄更斯借这番话警告埃比尼泽，他必须变得大方起来——比如说增加小蒂姆的父亲鲍勃的薪水，这样这个家庭就有能力购买更多食物。而且更重要的是，他们就有能力购买鱼油。如此一来，如果小蒂姆真的像现代医生诊断的那样，患有维生素D缺乏症，他的跛腿情况或许会得到不小的改善。我们并不确定小蒂姆为什么会缺乏维生素D。肾小管酸中毒（RTA）或软骨病，甚至软骨病加肺结核（都是19世纪伦敦儿童的常见病）都有可能造成这种症状。

7. 《荒凉山庄》中的库鲁克先生：失读症

“他可以写出所有的字母；当他看到单独的字母时，他也认得大部分……但他就是不能把它们放在一起。”

狄更斯以上述这番话，来描写《荒凉山庄》中商店主人库鲁克先生（Krook）的阅读能力。有些人提出，这可能是有史以来关于失读症的第一次文字记载。如果真是这样的话，那么狄更斯对失语症的记录，要比医学文献早了将近30年。同时库鲁克还有酒精依赖症状，他的死亡方式也不同寻常——人体自燃。

6. 《艾德温·德鲁德之谜》中的杰克：药物成瘾

《艾德温·德鲁德之谜》里的唱诗班指挥杰克（Jack Jasper）在鸦片的作用下，梦到了他内心深处最黑暗的欲望——勒死他的侄子埃德温（Edwin Drood）。同所有鸦片上瘾者一样，他试图将梦境化为现实。有心理学家怀疑梦境（特别是受药物影响的梦境），也许代表着人类内心深处的某种渴求，比如对食物和性的欲望。也许杰克对埃德温的未婚妻罗莎（Rosa Bud）的爱慕之情，也是促使杰克最终杀掉埃德温的原因之一（作家本人在作品完成前就去世了，所以我们可能永远无法得知，究竟是谁导致了埃德温的失踪）。在描写梦境、欲望和上瘾（现在已成为一种疾病症状）方面，狄更斯似乎是非常精准的。

5. 《远大前程》中的亚瑟·赫薇香：震颤性谵妄症

“和康佩森一起来的还有一个人，他名叫亚瑟……他身体极度衰弱，看起来就像游魂一般。”

在《远大前程》当中，狄更斯通过对亚瑟（Arthur Havisham，赫薇香小姐同父异母的哥哥）的描写，再次说明了成瘾的后果——身体和精神状况急剧下降。亚瑟受到“某些恐怖状况”的折磨，医生将之与震颤性谵妄症画上等号——这种症状常由戒酒造成，在酗酒人群中较为常见。正如它的名字所示，该症状的特征包括精神状态不稳定（谵妄）和身体颤抖（震颤性）。这两个症状都能在亚瑟身上找到。狄更斯的描写虽然委婉，但却道出了一个奇妙的“狄更斯症状”。

4. 《匹克威克外传》中的“胖小子”乔伊：肥胖肺换气不足综合症（OHS，也称匹克威克综合症）

在《匹克威克外传》中，狄更斯写道：“一个小伙子，一个惊人的胖小子……站在毯子上，腰板挺得很直；他双眼紧闭，好像睡着了一般。”

这段关于“匹克威克综合症”或“肥胖肺换气不足综合症”的描述堪称经典。虽然早在狄更斯描写“胖小子”Joe之前，就有关于该病主要生理症状的文字记录（过度肥胖和反常的白天困乏），但人们却是在很久以后才发现了这一症状与书中人物的联系——20世纪初，加拿大医生威廉·奥斯勒（William Osler）爵士在他所著的教科书《医学原则和实践》中首次提到。于是，在《匹克威克外传》（1837）出版了一个多世纪之后，“肥胖肺换气不足综合症”终于有了一个更通俗的名字——匹克威克综合症。

3. 《我们共同的朋友》中的布拉德利·韩德斯通：癫痫

“您病得可不轻，韩德斯通先生！”

“这没什么，先生。它很快就会过去。我已经习惯了这突如其来的晕眩。”

《我们共同的朋友》中的校长布拉德利韩德斯通（Bradley Headstone）被认为患有癫痫。的确，他那“突如其来的晕眩”很可能就是一次癫痫发作。韩德斯通并非狄更斯笔下唯一的癫痫患者。《雾都孤儿》中又邪恶又虚弱的僧侣，以及《荒凉山庄》中的女仆佳斯特（Guster）都曾经历过“癫痫发作”。有些人甚至猜测，狄更斯本人也曾受癫痫发作或类似症状的困扰，所以他对该病症了如指掌——但我们目前还没有任何实质证据来支持这种说法。

2. 《大卫·科波菲尔》中的乌利亚·希普：肌张力障碍

“当他试图表达强烈的情感时，他的身体就会扭动，真是十分难看。”

在狄更斯提到《大卫·科波菲尔》中的坏蛋乌利亚希普（Uriah Heep）时，常会使用“扭动”一词。有人认为，希普的持续扭动是“肌张力障碍”的标志。肌张力障碍是因不自觉的肌肉收缩而造成的重复动作。在社交场合，这些和肌张力障碍有关的反常扭动十分令人反感。狄更斯对此的描写非常到位。正像特拉伍德（Trotwood）小姐在希普面前说的那样，“如果您是一条鳗鱼，先生，就请您像鳗鱼一样生活；如果您是人类，就请控制好您的四肢，先生！看在上帝的份上！”

1. 《大卫·科波菲尔》中的毛切尔小姐：侏儒症

同样在《大卫·科波菲尔》中，读者们还会遇到一位侏儒症病患——理发师毛切尔小姐。和坏心肠的希普不同，毛切尔小姐可是个正面角色。然而狄更斯一开始似乎打算把她刻画成一个道德败坏的女人，但却遭到他当时的邻居——希尔（Jane Seymour Hill）夫人，一位侏儒症病患——的强烈反对。希尔夫人似乎曾用官司威胁过狄更斯，毛切尔小姐的种种美德大概正是狄更斯对她的补偿。后来，这个角色被当做是残疾人权利的标志，也是小说家给予弱势群体尊严的代表。

原文：

English novelist Charles Dickens had a knack for expertly portraying the symptoms of medical conditions. He also had a tendency to slip those descriptions into his works in subtle terms, such that historians and physicians have made it something of a hobby to interpret them medically and attempt to diagnose afflicted characters. In some cases, Dickens’s descriptions actually predated those offered by medical doctors, revealing his skill for observation. "Dickensian diagnoses" ascribed to nine of the novelist’s characters are explored in this list.

9. Ebenezer Scrooge

Fungus poisoning

On Christmas Eve in A Christmas Carol, miser Ebenezer Scrooge relives his past and has visions of the present and future in a series of vivid hallucinations. The following day, as detailed by Dickens, the mature-age (presumably 50-something) Scrooge was atypically generous and joyful. Scrooge’s complaint of indigestion on the night of the visions has been interpreted by some as evidence of poisoning with the hallucinogenic fungus ergot, which once was a common contaminant of rye bread. Others have suggested that Scrooge may have experienced a stroke or been afflicted by dementia or brief psychotic disorder.

8. Tiny Tim

Vitamin D deficiency

Whatever it was that ailed Scrooge, his visions in A Christmas Carol may have saved Tiny Tim Cratchit’s life. Indeed, Scrooge was warned, "If these shadows remain unchanged, I see an empty chair where Tiny Tim once sat." With this, Dickens suggests that if Scrooge were to be generous—to, for instance, raise Bob Cratchit’s wages—then the family would be able to afford more food. And, more important, they might have been able to buy fish oil, which, if modern-day physicians are correct in their assertions that Tiny Tim suffered from vitamin D deficiency, would have helped strengthen the boy's crippled legs. Why Tiny Tim may have lacked vitamin D is uncertain, though the condition may have been caused by renal tubular acidosis or rickets, or even by a combination of rickets and tuberculosis, which were common among London’s children in the 19th century.

7. Mr. Krook

Dyslexia

"He can make all the letters separately and he knows most of them separately when he sees them...but he can’t put them together."

That was how Dickens described the reading ability of shopkeeper Mr. Krook in Bleak House. Some have postulated that it might have been the first written description of dyslexia, and if that is the case, then Dickens penned it some three decades before the term itself reached the medical literature. Krook also suffered from alcohol dependency and died a most unusual death, having spontaneously combusted.

6. Jack Jasper

Drug addiction

In The Mystery of Edwin Drood, choirmaster Jack (John) Jasper, in the grips of opium, dreams his darkest desire—to strangle his nephew, Edwin Drood—an act that the opium addict ultimately seeks to realize. While still a mystery, some psychologists suspect that dreams, particularly those associated with drug use, may represent the origin of a craving or desire, such as for food or sex. Perhaps of significance, then, was Jasper’s love for Rosa Bud, Drood’s fiancée, which may have driven Jasper to kill Drood (though, the identity of the person responsible for Drood's disappearance is unknown; the author died before completing the novel). Thus, Dickens appears to have been spot-on in his portrayal of dreams, desire, and what is now a recognized medical condition—addiction.

5. Arthur Havisham

Delirium tremens

"There was another in with Compeyson, as was called Arthur…He was in a decline, and was a shadow to look at."

In Great Expectations, with the character Arthur Havisham, Dickens again demonstrates his knowledge of the consequences of addiction, namely its tendency to lead to physical and mental deterioration. Arthur suffered specifically from "the horrors," which physicians have equated with delirium tremens, a condition brought on by alcohol withdrawal and often seen in people who suffer from chronic alcoholism. As its name suggests, defining features of the condition include changes in mental state ("delirium") and shaking or shivering ("tremens"). Arthur suffers from both, as Dickens describes succinctly in the novel, making for a subtle yet intriguing treasure among Dickensian diagnoses.

4. Joe

Obesity hypoventilation syndrome

In The Pickwick Papers, Dickens described "…a boy—a wonderfully fat boy…standing upright on the mat, with his eyes closed as if in sleep."

It is a classic description of what is now known as Pickwickian syndrome, or obesity hypoventilation syndrome. While its primary physical features, obesity and atypical daytime drowsiness, appear to have been described prior to Dickens’s portrayal of Joe the fat boy, the first reference to the syndrome in relation to the novel appears to have made later, in the early 1900s,