Read the text and do the exercises that follow.

THE WORKING DAY OF A DISTRICT DOCTOR

In our country the basic medical unit is the out-patient clinic. Each polyclinic has its own laboratories, X-ray, physiotherapy, surgical and dental department, as well as numerous consulting rooms. There are polyclinics for the adult population and polyclinics for children in every residential area. Out-patients are seen by their district doctors.

As a rule the working day of a district doctor begins at nine o’clock in the morning at the polyclinic, where he sees about ten and sometimes even fifteen out-patients during his consulting hours. In the afternoon he usually makes his daily round of visits to the district. He examines all those patients, who are seriously ill and can’t come to the polyclinic. These patients must follow a strict bed regime.

Here are some of the cases a district doctor deals with during his consulting hours.

A young man entered the consulting room. He said that he felt rotten. Indeed, this patient was in a poor condition: his hands and face were damp with sweat; his pulse was accelerated and faint. He was running a high temperature. The doctor asked him to lie down on the couch and began questioning him thoroughly. Making the physical examination the doctor applied a stethoscope to the patient’s chest and listened to his lungs and heart. The patient’s respiration was accelerated and turned out to be 30 per minute. Some moist râles could be heard. The doctor made the diagnosis of lobar pneumonia and said that the patient had to be admitted to hospital. It was necessary to arrest the process in his lungs immediately to avoid any complications.

A woman of about 45 entered the consulting room next. She complained of a sore throat and a bad pain in her back, so that she couldn’t sleep last night. ―Well, the doctor said, ―let me have a look at your throat. I see, there is a bad inflammation. Is it hard to swallow? When the doctor examined her thoroughly it turned out the woman suffered from quinsy. He prescribed to her an antiseptic mouth-wash with which she had to gargle her throat five or six times a day. The doctor said it would give her an instant relief. As her condition was rather bad the doctor put her on a sick-leave for several days. A nurse had to come to her place to give penicillin injections. When the patient felt better she had to undergo a five-day course of physiotherapy. The doctor also advised her to apply mustard plasters to her back every other day before going to bed.

The next patient complained of a sharp pain in his stomach which increased after taking meals. The doctor questioned the patient on the character of the pain, palpated his abdomen and made the initial diagnosis of the ulcer of the stomach. But to be sure of his diagnosis the doctor directed the patient to be X-rayed. He prescribed to the patient a light diet. The patient had to follow it strictly, because heavy food wasn’t useful to him. The patient had to take the prescribed tablets before meals to relieve the pain.

After his consulting hours at the polyclinic the doctor usually makes calls to the district.

Here are some cases.

The doctor was called to two patients whom he had visited before. One of the patients was ill with lobar pneumonia, the other suffered from angina pectoris.

First he visited the patient ill with angina pectoris. Before examining the patient the doctor washed his hands, put on his white gown and only then entered the room, where the patient was lying. The doctor asked the patient: ―How are you feeling today? Do you feel any pain in the chest? Has your condition improved? The patient couldn’t say that the medicine he had been taking gave him any relief. The pain in the substernal area was particularly sharp on physical exertion. The doctor asked the patient to strip to the waist, listened to his heart and lungs, took his blood pressure, felt his pulse and palpated his abdomen. After five days of home treatment the patient did not feel any relief, and the doctor decided to hospitalize him.

Then the doctor visited the patient ill with lobar pneumonia. It was evident that the patient was recovering. He didn’t feel any pain in the chest. Cough disappeared and temperature returned to normal. The patient felt much better and was cheerful. He thanked the doctor for his kind attention and care. As the condition of the recovering patient was rather good the doctor advised him to be out in the open air as much as possible, to start his morning exercises again, to have rubdowns and by and by begin going in for sports.

In order to treat his patients the doctor should deal with every case carefully and attentively and try to calm those who are excited. In some cases the doctor’s words seem to act better than any medicine.

 

I. Practice the pronunciation of the following words and word combinations. regime - a bed regime, a strict bed regime, to follow a strict bed regime 

sweat - to be damp with sweat, his face is damp with sweat, his hands are damp with sweat

accelerate - accelerated, to be accelerated, his pulse was accelerated, the patient's respiration is accelerated

a stethoscope - to apply a stethoscope to smth, the doctor applied the stethoscope to the patient's chest, the doctor applied the stethoscope to my back

râles - moist râles, dry râles, the doctor heard moist râles, moist râles could be heard

respiration - the respiration is accelerated, the respiration turned out to be 30 per minute

lobar pneumonia - to make the diagnosis of lobar pneumonia, to be ill with lobar pneumonia, to fall ill with lobar pneumonia

inflammation - a bad inflammation, to have a bad inflammation, there is a bad inflammation, the inflammation of the throat

to swallow - it is hard to swallow, it hurts me to swallow, is it hard to swallow? you must swallow this tablet, swallowing, to feel pain on swallowing

quinsy - to be ill with quinsy, to fall ill with quinsy, to suffer from quinsy, to make the diagnosis of quinsy, to treat a patient for quinsy

a mouth-wash - an antiseptic mouth-wash, the doctor prescribed an antiseptic mouthwash, this antiseptic mouth-wash will be useful to you

to gargle - to gargle one's throat, to gargle one's throat three times a day, to gargle one’s throat with an antiseptic mouth-wash

relief - an instant relief, a great relief, a considerable relief, to feel a considerable relief, to give an instant relief

an injection - to give smb penicillin injections, to receive injections, a nurse gives this patient penicillin injections every day, to give a medicine by injection

mustard plaster - to apply a mustard plaster, a nurse applied mustard plasters to the patient's back, to apply mustard plasters every other day

initial - initial findings, initial findings were important, initial diagnosis, to make an initial diagnosis, to make the initial diagnosis of measles

ulcer - to suffer from an ulcer, an ulcer of the stomach, to have an ulcer of the stomach, to treat the patient for an ulcer of the stomach

a diet - a light diet, to prescribe to a patient a light diet, to follow a light diet strictly

to relieve - to relieve pain, these tablets relieve a bad pain, the course of physiotherapy relieved the pain in my side

angina pectoris - to be ill with angina pectoris, to fall ill with angina pectoris, to suffer from angina pectoris, to treat for angina pectoris

substernal - the substernal area, to feel pain in the substernal area, the pain in the substernal area was particularly sharp

physical exertion - on physical exertion, to feel pain on physical exertion, sometimes physical exertion causes pain

to hospitalize - to be hospitalized, to hospitalize a patient, this patient suffering from angina pectoris must be hospitalized

to calm - to calm down, to calm a person, the doctor must calm his patients; calm down, please.

II. Discuss the following questions in pairs:

1. What departments are there in every polyclinic?

2. When do you come to your district doctor?

3. What does the doctor start the examination with?

4. What does the examination usually include?

5. What does auscultation mean?

6. What kinds of râles do you know?

7. When are moist râles heard?

8. What must a doctor do to hear râles?

9. What is the best treatment for lobar pneumonia?

10. How must a doctor deal with his patients?

11. In what cases does a doctor put a patient on a sick-leave?

12. What patients should follow a diet?

13. What diet should a patient follow if he has an ulcer of the stomach?

14. What should you do if you have the inflammation of the throat?

15. What do you gargle your throat with if you have a sore throat?

16. When does a doctor advise his patient to apply mustard plasters?

17. Have you ever been ill with quinsy? 

18. What course of treatment do patients undergo for the grippe?

19. How many beats does your heart make per minute?

20. When may the pain in the substernal area be particularly sharp?

III. Find English equivalents for the following word combinations or sentences: 1. относиться к каждому больному заботливо и внимательно; 2. боль была особенно острая при физическом напряжении; 3. прописать больному легкую диету; 4. поставить горчичники на спину; 5. она жаловалась на боль в горле; 6. у него был ускоренный пульс; 7. обычно он делает ежедневный обход больных; 8. принимать таблетки до еды, чтобы снять боль; 9. врач выдал ей бюллетень на несколько дней; 10. остановить процесс в легких; 11. дыхание больного было учащенным; 12. его руки и лицо покрылись испариной; 13. больной выздоравливал; 14. тяжелая (грубая) пища; 15. пройти пятидневный курс физиотерапии; 16. сильное воспаление; 17. должны придерживаться строгого постельного режима;
18. разрешите взглянуть на ваше горло; 19. принести немедленное облегчение; 20. больного нужно было госпитализировать; 21. можно было прослушать влажные хрипы; 22. как вы себя чувствуете? 23. сестра должна была делать ей уколы пенициллина; 24. врач опрашивал его тщательно;
25. трудно глотать? 26. поставить первоначальный диагноз язвы желудка.

IV. Translate the following sentences into English:

1. Он медленно выздоравливал после длительной болезни.

2. Это лекарство может немедленно снять боль.

3. Так как больной жаловался на боль в желудке, врач должен был прощупать его (желудок).

4. У больного была такая резкая боль в печени, что его руки и лицо покрылись испариной.

5. Наш участковый врач обычно делает обход больных на участке днем, после приемных часов в поликлинике.

6. Ему нужно получить бюллетень, так как у него высокая температура.

7. В какой области науки работает ваш друг?

8. Что вас беспокоит? На что вы жалуетесь? — Боюсь, что у меня очень сильная простуда. Я чувствую себя отвратительно, и у меня болит горло.

9. Инъекции этого лекарства должны будут остановить процесс болезни. 10. Cестра сделала этому больному укол промедола, потому что у него были сильные боли в боку.

11. Больная очень бледна и жалуется на сильную боль в правой стороне живота. Ее нужно госпитализировать немедленно.

12. Я поблагодарил врача за заботу и внимание ко мне во время моей болезни.

13. Что с вашим другом? Он такой бледный, и на лице у него выступил пот.

14. При обследовании было обнаружено, что у больного учащенное дыхание. Когда врач прослушивал легкие, он обнаружил влажные хрипы.

15. У него воспаление легких. Он должен соблюдать строгий постельный режим, чтобы поправиться как можно быстрее.

16. Я делаю утреннюю зарядку и холодные обтирания каждый день.

17. Так как вы кашляете, у вас болит горло и вам трудно глотать, я пропишу вам таблетки и полоскание. Пожалуйста, полощите горло каждые два часа. Это скоро снимет боль.

18. Вы жалуетесь на боль в спине? Вам нужно поставить горчичники на cпину.

19. Сестра делала уколы этому больному через день.

20. Несколько дней тому назад врач прописал мне легкую диету. Я строго соблюдаю ее.