What cures colds, flu, sore throats, sore muscles, headaches, stomach aches, diarrhea, menstrual cramps, hangovers, back pain, jaw pain, tennis elbow, blisters, acne and colic, costs nothing, has no weird side effects and doesn't require a prescription?
　　什麼東西能夠治愈感冒、流感、咽喉疼痛、肌肉疼痛、頭痛、胃痛、腹瀉、月經痛、宿醉、背痛、下顎痛、網球肘、水泡、粉刺和疝氣，而不用花一分錢，沒有奇奇怪怪的副作用，且不需要醫生的處方？
　　Plain old-fashioned time. But it's often the hardest medicine for patients to take.
　　很簡單，也很過時，那就是時間。但是，這往往是病患吃過的最苦的藥方。
　　'Most people's bodies and immune systems are wonderful in terms of handling things -- if people can be patient,' says Ted Epperly, a family physician in Boise, Idaho, and president of the American Academy of Family Physicians.
　　愛達荷州的家庭醫生、也是美國家庭醫生學會(American Academy of Family Physicians)主席的艾伯利(Ted Epperly)說，如果大家可以耐心一點的話，大多數人的身體和免疫系統在應對疾病的時候都會表現很好。
　　'I have a mantra: You can do more for yourself than I can do for you,' says Raymond Scalettar, a Washington, D.C., rheumatologist and former chairman of the American Medical Association. But, he says, 'some patients are very medicine-oriented, and when you tell them they aren't good candidates for a drug they've heard about on TV, they don't come back.'
　　華盛頓特區的風濕病學家、曾任美國醫療協會(American Medical Association)前董事長的斯加列托(Raymond Scalettar)表示，他有一句話奉勸大家：患者能為自己做的比醫生能夠為患者做的更多。不過，他也說，一些患者十分迷信藥物，當你坦言，他們並不適合使用他們在電視上看到過的某種藥物，他們就不再回來了。
　　An estimated one-third to one-half of the $2.2 trillion Americans spend annually on health care in the U.S. is spent on unnecessary tests, treatments and doctor visits. Much of that merely buys time for the body to heal itself.
　　據估計，美國人每年花費在醫療保健上的2.2萬億美元當中，有三分之一到一半是花費在不必要的測試、治療和醫生門診上。其中很多步驟只是為身體自行痊愈購買了時間而已。
　　And while temporary relief from symptoms is nothing to sneeze at, it adds up to a considerable amount of spending: $5.4 billion annually on cough and cold remedies, $2.7 billion on headache remedies and $411 million on chest rubs and other analgesics, according to Nielsen Co. Americans also spend an estimated $1 billion on unnecessary antibiotics that don't even relieve the symptoms of viral infections, and contribute to antibiotic resistance. But some patients are so insistent on getting antibiotics that doctors give in.
　　雖然暫時緩解症狀並不是什麼值得輕視的事情，但是根據尼爾森公司(Nielsen Co.)的調查，這加起來可是一大筆開銷：每年有54億美元花費在咳嗽和感冒藥上，27億美元花費在頭痛藥上，4.11億美元花費在胸部按摩用止痛劑（chest rub）及其它止痛劑上。據估計，美國人每年還在不必要的抗生素類藥物上花費高達10億美元，而這些藥物甚至無法減輕病毒感染的症狀，反而會增強抗生素的抗體。但是，一些患者對使用抗生素非常堅持，以至於醫生也只好做出讓步。
　　'I have colleagues who say, 'You can take this pill and get better in two days, or do nothing and get over it in 48 hours,'' says Dr. Scalettar.
　　斯加列托醫生說，有同事這樣對病人說，你可以吃藥，兩天內可以恢復，也可以什麼藥都不吃，但也能在48小時內痊愈。
　　Even H1N1, or swine flu, for all the uproar, almost always resolves in a few days with no treatment. The Centers for Disease Control and Prevention is urging physicians to use Tamiflu, an antiviral medication, sparingly to prevent shortages and avoid antiviral resistance. Only people who are hospitalized or at high risk for complications should get Tamiflu, according to the CDC.
　　即便是喧囂一時的甲型H1N1流感幾乎也能在幾天內自行退去，而無需任何治療。美國疾病控制和預防中心(Centers for Disease Control and Prevention，CDC)正在敦促醫生謹慎使用抗病毒藥物達菲(Tamiflu)，以免出現短缺和病毒抗體。CDC表示，只有入院治療或者極有可能出現並發症的患者才應服用達菲。
　　The list of 'self limiting' maladies -- those that require no outside treatment -- range from minor annoyances to what might appear to be more serious musculoskeletal problems. 'Muscle aches and pain, minor traumas, sprains and strains typically do not need to be seen by a doctor,' says Dr. Epperly, who recommends his organization's Web site, www.FamilyDoctor.org, as a resource to look up symptoms and health concerns. 'Nausea, vomiting and diarrhea are typically time-limited. People will start to see improvement in two or three days -- just watch that you're not throwing up blood,' he says. If so, call your doctor.
　　所謂“自我限制”──那些無需外部治療的疾病的名單，從無關痛癢的不適，到看起來可能是更加嚴重的肌肉和骨骼問題，不一而足。艾伯利醫生表示，肌肉疼痛、輕微的創傷、扭傷和拉傷通常不需要醫生治療。他建議大家使用他所在機構的網站www.FamilyDoctor.org,作為查看各種症狀和健康顧慮的資源。他說，反胃、嘔吐和腹瀉通常都有時間限制。兩三天後大家就會開始看到症狀有所緩解，只要小心自己沒有吐血就好。如果真有吐血，那麼趕緊叫醫生。
　　Almost all viral infections resolve on their own, unless you have a compromised immune system. As a rule of thumb, Dr. Epperly says, infections in the nose, throat, stomach and upper respiratory tract tend to be viral. Infections elsewhere in the body are likely to be caused by bacteria, and those can get worse without antibiotics. About 80% of urinary-tract infections resolve on their own, for example, but about 20% develop into more serious kidney or blood infections. And even if they don't, the symptoms can be very uncomfortable.
　　幾乎所有的病毒感染都會自行痊愈，除非你的免疫系統本身就有問題。艾伯利醫生表示，根據經驗法則，鼻子、喉嚨、胃部以及上呼吸道通常很容易感染病毒。身體其它部位的感染有可能是因為細菌引起的，此類感染如果沒有抗生素的話可能就會惡化。比如說，80%的尿道感染可以自行痊愈，但是大約20%也會發展成為更加嚴重的腎部或者血液感染。即便沒有惡化，症狀也會極不舒服。
　　Parents are often extremely eager to 'do something' for children who complain of sniffles, stomach aches, scrapes and fevers. Yet kids are generally very resilient, writes Lara Zibners, an emergency pediatrician, in her book, 'If Your Kid Eats This Book, Everything Will Still Be Okay.' (For a fever, she advises calling the doctor if the patient is a baby younger than three months and has a fever over 100.4 degrees. For kids older than that, other symptoms are more important than the thermometer -- especially if a child is listless, irritable, unusually sleepy, refusing to eat or drink, or having trouble breathing.)
　　對於抱怨流鼻涕、胃痛、刮傷或者發燒的孩子，父母經常會極其迫切地要為他們“做點什麼”。然而，孩子對疾病的抵抗能力通常都很強，急診兒科醫生茲布納(Lara Zibners)在她寫的書“If Your Kid Eats This Book, Everything Will Still Be Okay”中這樣寫道。（如果遇到孩子發燒，她建議在患者不到三個月大並且體溫高於38度的情況下，父母需要致電家庭醫生。對於比較大的孩子，其它症狀比體溫更加重要──尤其是如果孩子情緒低落、急躁易怒、極度困倦、拒絕吃喝或者呼吸困難的話。）
　　Some chronic maladies follow predictable courses, according to many medical experts, whether or not they are treated.
　　許多醫療專家表示，一些慢性疾病的痊愈過程事先可以預見到，無論它們受到治療與否。
　　Colic is almost always gone in four months. Some 70% of acne is gone three to four years after it first appears. 'Frozen shoulder' -- a painful restriction of the shoulder joint -- is typically painful for three to six months and stiff for the next four to six months, and resolves completely after one to three more months. Temporomandibular joint (TMJ) pain tends to go away by itself in 18 months. Sciatica resolves on its own in three weeks in 75% of cases.
　　疝氣總是在四個月內就幾乎消失殆盡。大約70%的粉刺在首次出現後的三到四年裡會全部消失。患上“冰凍肩”──即粘黏性肩關節囊炎，肩部通常會疼痛三到六個月，接著會僵硬四到六個月，然後再過一到三個月就會完全康復。顳下頜紊亂(TMJ)通常會在18個月裡自行止痛。75%的坐骨神經痛會在三周內不治而愈。
　　For all the misery it causes, 80% to 90% of back pain resolves with only 'conservative measures' (which include anti-inflammatory drugs, rest, heat, physical therapy and chiropractic treatments). 'Sometimes it take days to weeks, sometimes it takes weeks to months, but pain lasts more than three months in only about 10% of cases,' says Michael J. Yaszemski, chief of orthopedic spine surgery at the Mayo Clinic in Rochester, Minn.
　　雖然背痛會給人造成很多不適，但是80%到90%的背痛僅靠“保守療法”即可痊愈，其中包括服用消炎藥、休息、熱療、物理療法和脊椎指壓療法。明尼蘇達州梅約醫院（Mayo Clinic）的整形脊柱外科主任雅斯曼斯基(Michael J. Yaszemski)表示，有時候會持續數天到數周，有時候會是數周到數月，但是疼痛超過三個月的案例只有大約10%。
　　Whether to operate even in those remaining cases is controversial, he says. With acute lumbar disc herniation, studies have found that two and five years later, there's little difference between patients who had surgery and those who did not. But surgery can sometimes provide relief faster.
　　他說，在剩下那些病例當中，對於是否需要進行手術治療還存在很大爭議。對於急性腰椎間盤突出症，研究發現，兩到五年後，那些做過手術和沒有做過手術的患者之間並無多大不同。不過，手術有時候可以更快地緩解疼痛。
　　'There are those patients who feel they just can't wait -- like Joe Montana,' says Dr. Yaszemski of the former San Francisco 49ers quarterback, who made headlines when he returned to playing football just eight weeks after spinal surgery in 1986.
　　雅斯曼斯基醫生表示，有些病人覺得他們根本無法等待，像喬•蒙大拿(Joe Montana)那樣。蒙大拿曾是舊金山49人隊的橄欖球四分衛，他曾經因為在1986年做完脊椎手術僅僅8周後就重新上場比賽而名噪一時。
　　Many patients are relieved to hear that they don't need to take medicine, have a blood test or undergo surgery for what ails them. But some feel embarrassed to have taken the doctor's time or frustrated because they think the doctor isn't taking their situation seriously. ('Much depends on the way you tell them,' says Dr. Scalettar. 'There are some arrogant doctors.')
　　許多患者聽到他們無需吃藥、進行血檢或者讓人備受折磨的手術會大感輕松。但是，也有一些患者因為占用醫生時間而覺得尷尬，或者因為覺得醫生沒有認真對待自己的問題而深感苦惱。（斯加列托醫生說，很多情況下取決於你如何告知患者。有些醫生很傲慢。）
　　And some patients resent paying for a visit when all the doctor provides is reassurance that they'll get better with time. 'If a patient says, 'You mean, I'm paying $100 for you to tell me there's nothing wrong?' I say, 'There is something wrong -- a virus,'' says Dr. Epperly. ''But more importantly, I can tell you what's not wrong: it's not meningitis or cancer or a brain tumor or some other life-threatening illness. And if the pain doesn't go away in a few days, please, please tell me, and we'll investigate further.''
　　當醫生所能提供的就是安撫病患病情會隨著時間推移逐漸好轉的時候，一些病患很不情願支付就診費用。艾伯利醫生說，“如果一個病人對我說，‘你是在說，你告訴我沒什麼問題，我還要付你每小時100美元？’我會說，‘確實有問題──是病毒。但是更為重要的是，我可以告訴你哪裡沒有問題：它並非腦膜炎或者癌症或者腦瘤或者其它一些危及生命的疾病。如果疼痛在幾天內還不消失，那麼務必聯系我，我們會為你做進一步的檢查。’”
　　'The longer you've known someone, the easier that conversation is,' Dr. Epperly adds.
　　艾伯利醫生說，你認識病患越久，這種對話就越容易。
　　Indeed, applying what some call 'a tincture of time' requires time on the doctor's part as well. Explaining why a medication or CT scan or MRI isn't necessary, or what signs to look for if an ailment isn't getting better, often takes more time than writing a quick prescription.
　　確實，向病人解釋為什麼沒有必要服藥，進行CT掃描或者核磁共振成像(MRI)，向他們說明在病情沒有好轉的情況下應該尋找哪些征兆，常常需要花費醫生更多的時間，遠遠不及開張處方來得那麼快。
　　Of course, there are symptoms that people should never ignore, since they could signal a serious illness or a condition that could get worse, not better, with time. Contact your doctor immediately if you experience any of the following:
　　當然，有些症狀大家永遠也不應忽視，原因是它們可能意味著可能只會隨時間推移惡化、而非好轉的嚴重的疾病或者狀況。如果你出現以下症狀，請務必立即聯系你的醫生：
　　-- Crushing chest pains -- the classic signs of a possible heart attack.
　　-- 胸部劇烈疼痛──這可能是心髒病的典型預兆。
　　-- Sudden numbness or weakness on one side of the body, confusion, trouble speaking or severe headache -- which could indicate a stroke.
　　-- 身體一邊突然出現麻痹或者感到無力、思維混亂、說話困難或者頭疼欲烈──這可能意味著中風。
　　-- Sudden, severe headaches.
　　-- 突然出現劇烈的頭痛。
　　-- Any major injury, especially involving loss of consciousness.
　　-- 遭遇大的創傷,尤其是涉及失去意識的傷害。
　　-- Coughing up, throwing up or excreting blood.
　　-- 咳嗽、嘔吐越來越厲害,甚至出血。
　　-- Suicidal or homicidal urges.
　　-- 有自殺或者行凶的衝動。
　　-- Flashing lights in your vision -- which could be a detached retina.
　　-- 看東西出現閃光──可能是視網膜脫落。
　　-- Inability to breathe -- which could be a severe allergic reaction.
　　-- 無法呼吸──可能是嚴重的過敏反應。
　　-- Recurrent tooth pain. 'You can typically give a tooth ache 24 hours,' says Dr. Epperly. 'If it's an abscess that would require a root canal, it won't get better by itself.'
　　-- 持續牙痛。艾伯利醫生說,通常牙痛會持續24個小時。如果是需要根管手術的膿腫,它不會自己好起來。
　　The bottom line: Don't hesitate to call your doctor if you have persistent pain or a loss of function or anything unusual for you. It's worthwhile to rule out something serious that does need medical attention. But if the doctor says you will get better on your own, that's a powerful prescription itself.
　　底線是：如果你出現持續不去的疼痛，或者失去某種功能，或者對你來說任何不同尋常的症狀，那麼不要遲疑，趕緊聯系家庭醫生。排除一些確實需要醫生觀察的嚴重疾病的可能性是值得的。但是，如果醫生說你會自己慢慢好起來，那麼這本身就是一劑強有力的處方。

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