沉睡之谜

这是一档iHeart播客节目。

This is an iHeart podcast.

大家好，我想花点时间聊聊Squarespace，特别是Squarespace支付功能。如果你正在经营生意并使用Squarespace，那你就做对了，因为Squarespace支付是集中管理付款的最便捷方式。开通流程快速简单，只需点击几下就能开始立即收款。

Hey, everyone. I wanna talk to you for a sec about Squarespace and specifically Squarespace payments. If you're running a business and using Squarespace, you're doing the right thing because Squarespace payments is the easiest way to manage your payments in one place. Onboarding is fast and simple. You can get started in just a few clicks and start receiving payments right away.

此外，你还能为客户提供更多支付选择，包括KlarnaACH直接借记（美国）、ApplePay、Afterpay（美加地区）和Clearpay（英国）等热门支付方式。只需访问squarespace.com/stuff即可获得免费试用，准备正式上线时使用优惠码stuff可享首单网站或域名10%折扣。

Plus, you can give your customers more ways to pay with very popular payment methods like Klarna ACH direct debit in The US, Apple Pay, Afterpay in The US and Canada, and Clearpay in The UK. Just go to squarespace.com/stuff, and you can get a free trial. And when you're ready to launch, use our offer code stuff to save 10% off your first purchase of a website or domain.

互联网是我们创造的产物，而非仅仅降临在我们身上的事物。

The Internet is something we make, not just something that happens to us.

我是布里奇特·托德，科技与文化播客《互联网上没有女孩》的主持人。新一季节目中，我将对话像阿尼尔·达什这样的互联网先驱创业者和作家——他始终拒绝以 cynicism 看待互联网。

I'm Bridget Todd, host of the tech and culture podcast, there are no girls on the Internet. In our new season, I'm talking to people like Anil Dash, an OG entrepreneur and writer who refuses to be cynical about the Internet.

我热爱科技，你知道的

I love tech. You know,

我这辈子都是个技术宅，但总要有个追求目标。不能只是为了技术而技术。

I've been a nerd my whole life, but it does have to be for something. Like, it's not just for its own sake.

这是一个鼓舞人心的故事，聚焦于人作为互联网的核心基石。请在iHeartRadio应用、苹果播客或任何你获取播客的地方收听《互联网上没有女孩》。

It's an inspiring story that focuses on people as the core building blocks of the Internet. Listen to There Are No Girls on the Internet on the iHeartRadio app, Apple Podcast, or wherever you get your podcast.

欢迎收听《你应该知道的事》，iHeartRadio出品。

Welcome to Stuff You Should Know, production of iHeartRadio.

嘿，欢迎收听本期播客。我是乔什，还有查克，杰瑞也在这儿。这是一期经典的老式‘你应该知道的医学谜题’节目。

Hey, and welcome to the podcast. I'm Josh, and there's Chuck, and Jerry's here too. And this is a good old fashioned stuff you should know medical mystery episode.

没错。看看那边的杰瑞，她就坐在那儿，一动不动。你可以这样做——乔什，不知道你知不知道。

That's right. Look at Jerry over there. She's just sitting there. She's frozen. And what you can do is I don't know if you know this, Josh.

如果你走到杰瑞旁边，把她的手从键盘上拿开，然后举过头顶

If you walk over to Jerry and take her hand off the keyboard and raise it above her head

嗯哼。

Mhmm.

她会一直保持那个姿势，直到你把手放下来。

She'll just keep it there until you move it back down.

查克，听上去杰瑞可能患的是慢性脑炎性昏睡症。

Why, Chuck, it sounds a lot to me like Jerry might have chronic encephalitic lethargica.

我觉得你说得对。

I think you might be right.

我可能是对的，也可能部分正确。如果当初我直接诊断她为昏睡性脑炎，或许会更准确些——但根据这些症状，她大概率就是这病。

I might be right. I might be partially right. I think I would have been more right if I had called it encephalitis lethargica, but that's probably what she has if those are her symptoms.

没错。这病例该归入《医学谜团》档案，同时也该标记为'茱莉亚事件'。不过我们姑且称之为EL或昏睡性脑炎。它还有个俗称叫嗜睡症，有时也叫昏睡病——虽然现在新型昏睡病和这个完全不是一回事。

That's right. File this under Medical Mysteries and also file it under Julia Jam. But we're basically gonna call it EL or encephalitis lethargica here and there. That was also known as the sleepy sickness, sometimes the sleeping sickness, although there's a new sleeping sickness that is not to be confused with the previous one.

对。新型的是由采采蝇传播，在非洲已呈流行趋势（虽然我认为还未形成地方性流行病）。症状虽有相似之处，但据我所知两者毫无关联。

No. It's spread by the tsetse fly, and it's epidemic I don't think it's endemic yet, in Africa. And it has got a couple of similar symptoms, but they're in no way related from what I understand.

没错。我们讨论的是二十世纪初始于1916年的欧洲疫情，患者会突然毫无预兆地丧失行动能力，有些人陷入类昏迷或类睡眠状态，多数人在数日内死亡。到1919年已蔓延至少四大洲，导致数十万人丧生。

That's right. We're talking about an outbreak that happened in the early twentieth century in Europe, starting at about 1916, wherein all of a sudden, people would, kind of out of nowhere, they would lose mobility. Some people would fall into like a coma like state or a sleep like state. Many many people would die within days. And it reached epidemic proportions in, at least four continents by 1919, killed hundreds of thousands of people.

它至今仍是医学未解之谜，因为我们仍不清楚疫情爆发的确切原因，也不明白为何会突然消失。

And it's a medical mystery because we still don't know exactly why it happened or why it just kinda suddenly went away.

是啊。它从何而来？是什么引起的？一无所知。我们几乎对它毫无了解。

Yeah. Where it came from? What caused it? Nothing. We don't know almost anything about it.

他们只是大致了解症状，以至于当如今极其罕见的病例出现时，你能说，我认为这实际上是昏睡性脑炎。你提到人们会陷入昏迷或类似睡眠的状态。那些罹患昏睡性脑炎的人，并非像睡美人那样仰卧双手交叠于胸前。而是像你说的，可能手悬在空中，嘴巴张开仿佛无声尖叫，眼睛睁着却完全不动，就那样僵坐着。这种可怕的症状可能折磨患者数十年。

They just kind of know the symptoms enough that when you see the very, very, very rare case come along these days, you can say, I think this actually is encephalitis lethargica. And there was something you said about people being struck into like a coma or sleep like state. The the people who are struck with encephalitis lethargic, they weren't like laying there like Sleeping Beauty on their backs with like their hands crossed over their chest. Like, it was like you're saying, like, they might have their hand in the air and their mouth open in like a silent scream and their eyes were open and they just weren't moving at all, and they were just sitting like that. That's the kind of like horrible symptom that you could suffer from for decades.

一旦发作，这种状态可能伴随余生，即便发病时还是个孩子。

Like once that started, it might just keep going on for the rest of your life even though this happened to you in childhood.

没错。所以这里我们要保留一点悬念。但开场不会直接揭晓，毕竟三幕式结构不是这么玩的。

Yeah. Exactly. So and there's a bit of a a reveal that we're gonna hang on to here. But we're gonna start off with not a reveal, because it's not how you do things in the three act structure.

播客行业可不兴这么搞。

Not in the not in the podcast biz.

不不不。我们要从1916年开始讲起，主角是康斯坦丁·冯医生——是读economo还是economo来着？

No. No. No. We're gonna start out in 1916 with a doctor Constantin von is it economo or economo?

我倾向第一种发音。

I like the first one.

这就像在问，是经济还是经济？

That's like saying, is it economy or economy?

听起来像是Cosmo Kramer的化名。

This sounds to me like a a Cosmo Kramer alias.

你为什么不直接告诉我你想看哪部电影？那个桥段我每次都会笑。

Why don't you just tell me the name of the movie you want to see? I'll never not laugh at that bit.

不，这是个好问题。

No. It's a good one.

哦，天哪。他当时是维也纳大学精神病神经科诊所的医生。1916年，他开始在诊所遇到一些奇怪的病例，症状显示病历上的诊断是脑膜炎、多发性硬化或谵妄等，但这些症状与这些疾病或其他他能想到的任何情况都不吻合。

Oh, boy. So he was a doctor, at the University of Vienna's Psychiatric Neurological Clinic. And he started seeing some some strange cases come through his office in 1916 where the symptoms were, you know, they had diagnoses on the charts, things like meningitis or MS or delirium, but the symptoms weren't matching these things or anything else that he could think of.

是啊。

Yeah.

他做的第一件事就是排除了神经毒素、感染和神经系统疾病的可能性，然后说，好吧，我持开放态度。既然没人知道这是什么，我们需要弄清楚，所以让我们集中精力解决这个问题。

And the first thing he did was ruled out neurological toxins, infections, and neurological disorders, and then was like, alright, I'm open here. Let's, like, no one knows what this is, and we need to figure it out, so let's sort of put our minds to this thing.

是的，他深入研究了。他开始描述它。他并非第一个描述的人。我认为他甚至被一位名叫雷内·克鲁塞特的法国医生抢先了几天，尽管有人说情况恰恰相反。

Yeah, he dove in. He started describing it. He wasn't the first one to describe it. I think he was actually beaten by a couple of days, even though some people say it was the opposite way around, by a French physician named Doctor. Rene Crucette.

区别在于克鲁塞特医生的观点是这可能是一种行为障碍，而冯·埃科诺莫医生则认为，不，这明显是某种感染或类似的东西。这是一场流行病。它是可传播的。

The difference was Doctor. Crucette's take was that this was maybe a behavioral disorder, and Doctor. Von Economo said, no, this is clearly some sort of infection or something like that. It's an epidemic. It's transmissible.

所以这就是为什么它有时被称为冯·埃科诺莫脑炎。基本上是以他的名字命名的，因为他是那个指出问题所在的人。他认为事情是这样的。看看这些不太典型的症状。

So that's why this is sometimes called Von Economo encephalitis. It was essentially named after him, because he was the guy who said, this is what's going on. This is what I think is going on. Check out these not so symptoms.

没错。一开始并不那么疯狂，因为人们最初来的时候，基本上看起来像是流感。你知道的，发烧、咳嗽，就是大家都会想到的流感症状。对吧？是的。

Right. Not so nutso at first, because when people would come in at first, they had basically, it looked like the flu. You know, fever, coughing, know, kind of what you would think of everyone's had the flu. Right? Yeah.

我不必...我不必...是的。就是这样。那就是...

I don't have to I don't have to yeah. There you go. That's what

你...我最近看了《超级名模》。

you're I watched Zoolander recently.

你知道，一图胜千言。乔什模仿流感的表演至少抵得上我的二十句话。

You know, a picture is worth a thousand words. A Josh impression of the flu was worth at least 20 of my words.

好的。谢谢。

Alright. Thanks.

我很感激。那是《超级名模》里的情节吗？他有吗？

I appreciate it. Was that part of Zoolander? Did he?

是的。他得了黑肺病。当时他回家和他父亲一起挖煤。

Yeah. He had the black lung. When he went back home to mine coal with his dad.

哦，我喜欢那部傻傻的电影。

Oh, I love that dumb movie.

那确实是一部很棒的傻电影。感觉就是，现在看依然很棒。

It is a really great dumb movie. Was like, this is pretty great still.

好的。最初是类似流感的症状，然后出现一系列非常不一致的神经系统症状，患者之间的严重程度也相当不一致。有时差异极大。但这些神经系统症状中最常见的线索之一是一种叫做嗜睡症的状况，就是感觉非常、非常困倦，最终可能导致那种昏迷般的状态，仿佛被锁在里面一样。

Alright. So flu like symptoms at first, then just a huge array of neurological symptoms that were really inconsistent among the patients. The severity of which was pretty inconsistent. Sometimes it varied wildly from one to another. But one of the most common threads of these neurological symptoms was something called hypersomnolence, which is just really, really sleepy, like feeling really sleepy, and then eventually it could lead to that coma like state where you're just sort of locked in.

所以事情是这样的。这种睡眠，那种在昏睡性脑炎患者中常见的睡眠类型，并不是你认为的那种睡眠。不是休息。你可以很容易地唤醒他们。嗯哼。

So here's the thing. I so the sleep, the type of sleep though that is the like common among people struck with encephalitis lethargica is not what you would consider sleep. Not getting rest. You can wake them very easily. Uh-huh.

他们可能在睡眠期间对周围发生的事半知半觉，但又无法抗拒睡意。这种嗜睡症还有个表现是动作突然停滞，比如正吃着西兰花时突然僵住——这个例子可能不太恰当，因为他们大概会想'我实在吃不下去这恶心的西兰花'。但假设他们正在吃美味的小动物饼干，却突然停在咀嚼动作中。他们可能就此静止，也可能因为听到某首歌之类的外界刺激，突然又继续吃起饼干来。

They are probably semi aware of what was going on around them the whole time they were sleeping, but they they couldn't not fall asleep. Another thing that sometimes gets chalked up under this hypersomnolence is freezing mid action, like maybe they're taking a bite of broccoli. That's a that's a bad example, because they probably are like, I can't make myself eat this broccoli, it's so disgusting. But let's say they're eating like a delicious animal cracker, and they stopped mid bite. They're they might not move again, or they might like hear a song or something like that, and all of a sudden they start eating the the the animal cracker again.

对。关键在于这种病被称为'昏睡症'，但和你理解的正常睡眠完全不同。

Yeah. It's not the point is you it's called the sleeping sickness. It's not sleep as you would understand Right.

明白了。谢谢你的澄清。说真的，'昏睡症'这名字现在听起来还挺诱人的。

Yeah. Yeah. That that's good to clear that up. Thanks. Because sleeping sickness sounds pretty good to me right about now.

确实有点。

Kinda does.

这些病例的年龄跨度很大，约半数患者集中在10到30岁之间。正如所说，很多患者最终死亡，有些人在症状出现后一两周内就去世了。有个案例是女孩从音乐会回家途中突然瘫痪，半小时内陷入昏睡，不到两周就离世了。

Half of these cases, it was pretty wide age range. About half of them were in people aged 10 to 30. Like I said, a lot of the patients died. Sometimes they died within like a week or two after onset of symptoms. There was one case of a girl who was walking home from a concert, suddenly experienced a paralysis, fell asleep within about a half hour, and died less than two weeks later.

还有些更诡异的现象——我们稍后会提到——与精神症状相关。有些人患病几周后看似康复，性格却彻底改变。有份研究报告记载了四个病例，患者在痊愈后出现了偷窃癖。可以说这病能以任何方式扭曲人的心智。

There was also some weird stuff, as we'll see, that had to do with psychiatric symptoms, where sometimes people would be fine after suffering from this for a couple of weeks, but their personality would have changed. There was one report of, or I guess a study found four reports of people who developed kleptomania after having suffered this and then ostensibly were cured from it. So like it could really mess with your head essentially in just about any way your head can be messed with.

薇诺娜·瑞德当年偷东西时也这么声称过吗？还记得她那件事吗？

Did Winona Ryder claim that? What was her remember when she was stealing stuff?

哦，对了。我记得。那是个

Oh, yeah. I remember. It was a

太奇怪了。

So weird.

那可是件大事。

It was a big deal.

她复出后表现相当强势，这让我很高兴。我喜欢薇诺娜·瑞德，她在《怪奇物语》里演得很棒。

She came back pretty strong, which I'm glad. I like Winona Ryder. She does a great job in Stranger Things.

哦，她演过的每部作品都很出色。《希瑟姐妹》，老兄，那可是永恒的经典。她在《风情妈咪俏女儿》里也很棒。然后一路到《阴间大法师》。我不会连说三遍阴间大法师，但绝对是《阴间大法师》。

Oh, she's awesome in everything she's ever been in. Heather's, dude, is one of the all time great movies. She was great at Mermaids. And then, yeah, all the way through to Beetlejuice. I I'm not gonna say Beetlejuice Beetlejuice, but definitely Beetlejuice.

当然还有《怪奇物语》。

And then Stranger Things, sure.

是啊。还是X世代许多人的梦中情人。

Yeah. And a great crush of much of Gen X.

当然。

For sure.

无论男女。你听好了。我们说的是X世代的男女。

Both dudes and chicks. You got that straight. We're talking Gen dudes and chicks.

X世代会这么说。没错。他们确实这样。

Gen X says that. Yeah. They do.

好的。冯·艾克诺莫当时在研究所有这些人。他研究的是这些人的尸体。最终他将病症细分成了几个亚型。第一种是急性EL。

Alright. So Von Economo was studying all these people. He was studying corpses of these people. He he finally breaks it down into its subgroups. The first of which is acute EL.

这是最初会出现的信号。我们讨论过类似流感的前兆症状，以及随后出现的各种神经系统症状。然后他又将其分为三种形式，按从最常见到最不常见排序，最常见的是嗜睡性眼肌麻痹型。这个词怎么念？眼肌麻痹？

That is the initial signals that you're gonna get. We talked about the the flu y kind of stuff that you get and all these neurological symptoms that are gonna follow. Then he broke those down into three forms, from most common to least common, starting with the most common, somnolent ophthalmoplegic. How would you say that? Ophthalmologic?

眼肌麻痹型。

Ophthalmoplegic.

我就这么念了。

That's what I'm going with.

好的。这是最致命的一种形式。超过一半的患者在患上这种形式后会死亡。这种极度嗜睡的症状确实令人难以承受，但正如你所说，患者仍有意识，容易被唤醒。嗯。

Alright. That's the most deadly form. More than half the patients die when they have this form. This is really overwhelming sleepiness, but like you said, you're aware, you're easy to wake up. Mhmm.

最典型的部分是眼肌麻痹，所以你的眼睛无法移动。如果有人在你面前挥手，你的眼睛也不会跟随移动。此外还有你提到的那些神经精神症状，比如偶尔出现的谵妄、意识混乱、紧张症、木僵状态等等。

The the optimal part is ocular paralysis, so you have you're not moving your eyes. So if people come and they wave their hand in front of your face, your eyes aren't moving or anything like that. And also those neuropsychiatric symptoms that you were talking about, like delirium sometimes, confusion, catatonia, stupor, stuff like that.

我还看到过最骇人的病例报告——虽然我本人没遇到过类似情况——但经查证确实有个三十年代的案例，一个小女孩因此病出现精神崩溃，她拔光了自己所有的牙齿并挖出了双眼。一个小女孩竟然...这再次说明，虽然只是个离奇的极端症状，但随着我们深入探讨，你会发现这本质上就是大脑在某些可预测区域被逐渐侵蚀的过程。它就像引发了一连串或星系般的症状，都是大脑可能遭遇的最可怕状况。

There was also the worst report that I saw and, like, I didn't see anything like this, but I checked and it does seem to have been a case report of a girl from the thirties who basically had a psychotic break because of it, and she pulled out all of her own teeth and gouged out both of her eyes. A little girl did because And of again, it's just some weird outlier symptom, but as you see, we get further and further into this, it's just the brain getting eaten up somehow, some way, in some fairly predictable regions. So, it's creating this whole cascade or galaxy of different symptoms that are just the worst things that can happen to your brain happening.

是的。接下来是第二亚型，按发病率排序的话——取决于你如何看待——是运动亢进型。主要表现为躁狂发作，这是该型的核心特征。患者会经历躁狂期。

Yeah. The the next subgroup, next least common, or I guess the next most common, depending on which way you're looking at it, is hyperkinetic. That is mania, basically, the big part of this one. You have a manic phase.

嗯。

Mhmm.

伴随不自主发声和抽搐样动作。然后是轻躁期，表现为严重疲劳、虚弱。可能出现幻觉，四肢和面部神经痛。还有个典型症状是睡眠模式昼夜颠倒——如果你是工厂工人之类的话，可以说是夜昼颠倒。

Involuntary vocalizations and and kind of herky jerky movements. And then a hypomanic phase where there's a lot of fatigue, a lot of weakness. You can hallucinate. You can have nerve pain in your limbs and in your face. And this is one of the the otter symptoms is your sleep pattern will flip from day to night or I guess night to day if you were a factory worker or something.

嗯。关于昏睡症部分还有个现象，就是睡眠完全紊乱。我查过资料，至少在某些病例中，患者可能极度困倦却无论如何都无法入睡。这听起来比其他多数症状更折磨人

Mhmm. And there's another thing with that sleeping sickness part, know, like the your sleep is messed up. I also saw Chuck that in at least one of these, people might also be super sleepy but not be able to fall asleep no matter how hard they try. Which sounds worse to me than most of the

其他事情。确实如此。

other stuff. For sure.

他提到的第三种表现最为罕见，但也是一种可能的症状形式，称为无张力性运动不能（amiostatic akinetic），即无法自主运动。这正是昏睡性脑炎的经典形象描述：患者如同雕塑般静止，右臂悬空，左臂稍低，嘴巴微张，完全处于冻结状态。除非有人轻微施压于其手臂，否则患者不会移动肢体——但并非施压后患者就会自行放下手臂，而是需要他人手动将其臂膀放下，这种现象被称为蜡样屈曲。

There's a third one that he said is the least common, but it's also a way that it can present. It's called amiostatic akinetic, which is you can't move, akinesis. And this is kind of what the classic idea of what encephalitis lethargica looks like, where you're just sitting there with like, yeah, your right arm's in the air, your left arm's a little further down, your mouth's open, you're you're basically a statue essentially is how it's described. You're frozen in place and you're not going to move until somebody maybe put some slight pressure on your arm and then maybe you'll move it down. But it's not like they're just gonna put pressure on your arm for a second and then you move your arm down, like they have to move your arm down and this is what's called waxy flexibility.

处于这种状态的患者可以被摆成任何姿势。因此对待此类病人时需要格外温柔。

You can pose somebody in this state any way that that you want them to. So you have to be very kind when you're dealing with patients like this.

是啊。我忍不住觉得'蜡样屈曲'听起来像张专辑名。

Yeah. I could not help but think that waxy flexibility sounds like an album title.

确实。

For sure.

比如'指引之声'这类乐队？

Like Guided by Voices or somebody?

唇齿公司乐队。

Lips Inc.

那是个真实的乐队吗？

Is that a real band?

是啊，他们是放克小镇乐队。

Yeah. They're Funkytown Oh.

哦。哦。哦。好吧。是的。

Oh. Oh. Oh. Okay. Yeah.

噢。蜡状柔韧度？当然。

Oh. Waxy Flexibility? Sure.

嗯。

Mhmm.

搞定了。伙计们，男孩嗓音。我当时在想什么？

Nailed it. Guys, boy voices. What was I thinking?

对我来说，这是整件事最关键的部分，因为涉及睡眠问题，那些遭受此症的人，包括那些可能以蜡像形态固定数年甚至数十年的人，他们的意识是清醒的。他们并非像闭锁综合征患者那样，虽然能感知周围发生的一切却无法动弹。

This is the biggest part to me that's I guess part of all of this, because of the sleeping part, the people suffering this, including the people who are wax figures frozen in place for years or decades potentially, are there mentally. They're not like locked in, as in locked in syndrome, where they know every single thing that's going on around them at all times.

对。

Right.

但他们本质上处于相同的困境中——他们能感知事物，意识到时间的流逝，知道有人来来往往并与他们互动。他们无法回应，不能说话，不能转动眼球，无法集中注意力，做不出任何能向他人暗示‘嗯’的动作。他们以任何形式存在的迹象都无法展现。直到一个真正的医学奇迹发生，我们才恍然大悟：天啊，这些人一直清醒地存在于自己的意识中。他们并非像昏迷那样完全丧失意识。

But they're essentially in the same boat where they're aware of stuff, they're aware of thing time passing, there were people coming and going and interacting with them. They cannot respond, they can't speak, they can't change their position of their eyes, they can't focus their attention, they can't do anything that would suggest to anyone Mhmm. That they are there in any way shape or form. And it wasn't until a a genuine medical miracle took place that we understood, oh my god, these people have been there in their heads the whole time. They're not just like comatose, like just completely out of consciousness.

他们是有意识的。

They're conscious.

是的，确实如此。要知道，之前我说他们像是被‘锁住’了，并不是指字面意义上的闭锁综合征。

Yeah. Yeah. For sure. And you know, earlier I said like they're locked in. I didn't mean the literal locked in syndrome.

我只是想说，他们看起来像是被禁锢住了。

I just meant sort of, you know, look like they're locked in.

明白，是的，我没有误解你的意思。

Right. Yep. I didn't take it like that.

对，但我觉得其他人可能会误解，所以...确实。

Yeah. But I think people might have, so. Yeah.

好吧，大家加把劲。

Well, come on guys.

我们不清楚具体有多少病例。但那确实是一场真正的疫情。这是难以诊断的疾病之一。他们认为实际病例被低估且漏报严重。估计数字从五十万到超过一百万不等。

We don't know how many cases there were. It was a legitimate pandemic though. It's one of the things that was hard to diagnose. They think it was under diagnosed and reported. Estimates run from five hundred thousand to more than a million.

但他们认为可能有一半病例根本未被上报，所以实际数量难以估量。嗯。其中约三分之一死亡，三分之一幸存且基本康复，还有三分之一幸存后再次感染。这就是急性EL。或许我们该休息下，稍后再讨论慢性EL？

But they think that maybe half of the cases weren't even reported, so who knows how many it could have been. Uh-huh. And about a third of them died, a third survived and were kind of okay, and then a third survived and then got it again later on. And that is acute EL. So maybe we should take a break and talk about chronic EL after this?

好的。我们马上回来。

Let's. Alright. We'll be right back.

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好的，查克。我之前提到的那些症状，比如人们像雕像一样僵住，有蜡样屈曲、缄默症、紧张症，无法回应或移动。当我说持续数年甚至数十年时，更准确地说，我指的是慢性昏睡性脑炎。因为在我看来，它基本上就像长期的无动性紧张症，持续很多年。

Okay, Chuck. So a lot of the stuff I was talking about, about people being frozen in places if they were statues, they had waxy flexibility, mutism, ketonia. They weren't able to respond or move or anything. When I said for like years or decades, more accurately, I would have been referring to the chronic form of encephalitis lethargica. Because it was essentially, it seems to me, kind of like amniostatic akinetic, but for years and years.

嗯。

Mhmm.

最可怕的是，你经历了标准昏睡性脑炎的病例，就是我们刚讨论的三种之一，然后好转了。你可能差点死去，也可能康复，但也许行为发生了变化，比如变成了偷窃癖之类。是的。或者你康复了以为一切正常，但突然像被一吨砖头砸中，从此再也无法动弹，尽管距离你患昏睡性脑炎已经过去了十年。

The scariest part about all this was that you had gone through the standard case of encephalitis lethargica, one of those three that we just talked about, and got better. You may have died, you may have gotten better, but maybe you had like behavior changes, like you turned into a kleptomaniac or something like that. Yeah. Or you got better and thought everything was fine, but then you suddenly suffered from being just a ton of bricks being dropped on you, and all of a sudden you can't move for the rest of your life, even though it's been ten years since you had that case of encephalitis lethargica.

是的，确实如此。慢性症状与早期大致相同，但增加了一些症状，其中有一个非常、非常奇怪。你可能会出现情绪波动，这相当正常。欣快感甚至性欲增强，这还不算最奇怪的。约30%的患者会出现精神症状，同样，这并非世界上最异常的现象，但过度傻笑和频繁使用双关语确实是他们在急性病例中反复观察到的实际症状。

Yeah, for sure. The chronic is much the same as the earlier, but with a few added symptoms, one of which is very, very strange. You can have mood swings, pretty pretty normal. Feelings of euphoria and maybe even an increased libido, which is not the weirdest thing. Psychosis in about thirty percent of patients, again, not the the most abnormal thing in the world, but excessive silliness and the use of puns was an actual symptom that they saw over and over again in acute cases.

是啊。这不是很诡异吗？

Yeah. Isn't that bizarre?

或者说慢性病例中的非急性表现。

Or not acute in chronic cases.

对。没错。是的。但重申一下，最典型的特征——人们会指着说‘这人患有慢性昏睡性脑炎’的，就是我刚才提到的那个雕像状态，临床上更准确的称呼（而非‘雕像状态’）是‘脑炎后帕金森综合征’。帕金森综合征属于那种你越想搞懂就越困惑，直到放弃过度思考才能理解的东西。

Right. Yep. Yeah. But again, the defining trait, the one that people would point to and be like, that person has chronic encephalitis lethargica, is that statue thing that I was talking about, and that's more clinically called, rather than that statue thing, doctors tend to call it post encephalitic parkinsonism. And parkinsonism is one of those difficult things to grasp until you just stop trying to think too hard about it.

它本质上是一系列运动和神经功能症状及障碍。帕金森病包含帕金森综合征，但并非所有帕金森综合征都是帕金森病。

It's essentially a bunch of movement and neurological symptoms and dysfunctions. And Parkinson's includes Parkinsonism, but not all Parkinsonism is Parkinson's disease.

没错。

That's right.

好吧。我花了远比自己愿意承认的更长时间才终于搞清楚这一点，不再兜圈子试图弄明白。

Okay. It took me way longer than I care to admit to finally just nail that down and stop running in circles trying to figure it out.

是的。我是说，想想他们甚至称之为脑炎后帕金森综合征的原因？帕金森综合征。对。天哪，这真是个难题。

Yeah. I mean, think they even of the reasons they call it post encephalitic parkinsonia parkinsonism? Parkinsonism. Yeah. Jeez, that's a tough one.

我知道。

I know.

或者用PEP来区分它与帕金森病，因为两者并不完全相同。

Or PEP is to distinguish it from Parkinson's, which isn't exactly the same thing.

没错。其中一个重要区别在于，虽然两者有许多相似症状，但脑炎后帕金森综合征与帕金森病的不同之处在于：帕金森病会以可预测的模式逐渐恶化。而脑炎后帕金森综合征，就像我说的，可能突然发作。你可能正坐着吃动物饼干，突然之间——这辈子都再也没法吃完那块饼干了。它可能毫无征兆地降临，当你正过着正常生活时，转眼就被送进疗养院，余生都无法再动弹——除非你恰好身处1960年代末那个正确的时间与地点。

Yeah. And one of the big things that distinguish it, because a lot of that shares a lot of symptoms, but one of the things that distinguishes post encephalitic parkinsonism and parkinson's disease is that parkinson's disease progresses gradually in a predictable pattern. Post encephalitic parkinsonism, like I said, it can come out of the blue. You could be, again, sitting there eating an animal cracker, and all of a sudden, you never finish eating that animal cracker for the rest of your life. It can suddenly come out of nowhere, and you're just living your normal life, and then all of a sudden, you're in an institution, and you're bound never to move again unless you happen to be in the right place at the right time in the late nineteen sixties.

正是如此。现在要揭晓重磅关联了：如果你听到这些症状时觉得'这听起来耳熟，好像在哪部电影里见过'，那么你想对了。这就是改编自同名书籍的电影《无语问苍天》，原著是神经学家奥利弗·萨克斯的著作。嗯。讲述他1960年代治疗EL患者（昏睡性脑炎患者）的经历。

That's right. And this is the big reveal. If you were hearing these symptoms and you think, hey, that sounds awfully familiar, I think I saw a movie about that, Then you are correct. This is the movie from the book Awakenings based on neurologist Oliver Sacks' book of the same name Mhmm. About his work with EL patients in the nineteen sixties.

我记得1966年他在纽约布朗克斯区的贝斯·亚伯拉罕医院治疗了80名慢性EL患者。当这个病例出现时，奥利弗·萨克斯参与其中，而EL病症基本上已经消失了。它成了医学史上的一个脚注，1960年代甚至没多少人了解它，因为这种病就像——人们始终没搞清病因、起源、治愈方法等等。它就那么莫名其妙地消失了，所以所有医生都想着'好吧，谢天谢地'。

I think there were 80 chronic EL patients he worked with at Beth Abraham Hospital in the Bronx, New York in 1966. When this came around and Oliver Sacks was in there, e l EL had had gone away, basically. It was a medical footnote, and not a lot of people in the nineteen sixties even knew much about it because it was one of those things that, like, they never figured out what it was or how it started or how to cure it or anything. It kinda just went away, so every all the doctors were like, alright. Thank god.

我想我们不用再担心这个了。

I guess we don't have to worry about that anymore.

对，正是如此。

Right. Exactly.

然后他们就继续忙其他工作了。1985年NPR的一次采访中，他谈到动作时这样描述（引用原话）：'静止的人物以怪异姿态凝固，有时姿势相当戏剧化，有时则不然，完全没有动作迹象，一切仿佛冻结。'这正是电影《无语问苍天》中罗伯特·德尼罗饰演的角色状态。

And they just moved on to their other work. There was a 1985 NPR interview where he was talking about motion this is a quote, motionless figures who were transfixed in strange posture, sometimes rather dramatic postures, sometimes not, with an absolute absence of motion, without any hint of motion, so everything looked frozen. And that was, you know, Robert De Niro's character in the movie Awakenings.

没错。还有他最终聚集起来的其他病例。嗯，整合在一起。你上次看《无语问苍天》是什么时候？

Yeah. And all the others that he eventually grabbed together. Yeah. And assembled. When was the last time you saw Awakenings?

有段时间了。不过我记得当时觉得那是部相当不错的电影。

It's been a while. I think I remember thinking it was a pretty good movie back then, though.

这是部杰作。对，我昨晚刚重温。你知道导演是谁吗？

It's a great movie. Yeah. I watched it last night. Who directed that? Do you know?

拉弗恩。

Laverne.

哦，是潘妮·马歇尔执导的吗？

Oh, was that Penny Marshall?

是啊。

Yeah. Did

太棒了

a It great

太棒了。我是说，我不记得德尼罗有没有拿过奥斯卡，但如果没有，那绝对是史上最大的遗珠之一。他演得太出色了。我都忘了罗宾·威廉姆斯有多棒，天啊，那家伙真是个了不起的人。

was great. I mean, like, I don't remember if De Niro got an Oscar or not, but if he didn't, that's one of the all time great snubs. He did amazing. I forgot how wonderful Robin Williams is to just, man, what a great guy that dude was.

了不起的家伙。

Great dude.

太棒了

Great

电影今天早上看了关于他的东西，非常非常难过的事。

movie was watching a thing with him this morning and very very sad stuff.

你当时在看什么？

What were you watching?

那是他在Instagram上发布的一张与母亲的合照，照片里他母亲逗得他开怀大笑。我觉得整篇帖子的重点在于，你很少能听到罗宾·威廉姆斯那种发自内心的笑声。

It was an Instagram post of him with his mother and his mother making him laugh. And I I think the whole point of the post was like, you rarely got to hear Robin Williams' like genuine laugh.

嗯哼。

Mhmm.

当我听到时，我就想，确实。我不确定自己是否真的听过那样的笑声。而他母亲竟能让他笑得如此开怀，真的很温馨。你能模仿一下吗？

And I heard it, and I was like, yeah. I don't know if I've really ever heard that. And his mom made him laugh that hard. Was really sweet. Can you do an impression?

那种笑声挺特别的。哦，当然不是完全一样。但那是种充满活力的笑，不像我那种傻里傻气、孩子般的笑声。

It was kind of a thing. Oh. I mean, not like that. But it was exuberant, but it was like, Not like my my goofy, childish laugh.

我懂你的意思。是啊，所以这是部好电影，而且百分百基于这个事实。有趣的是，他们甚至费心把奥利弗·萨克斯书中的人名都改了。

I got you. Yeah. So good movie, and it was a 100% based on this. So much so that it's funny, they they went to the trouble of changing the names of the changed names that Oliver Sacks had in the book.

哇哦。

Wow.

所以没错，《无语问苍天》在很多方面都相当忠实原著。虽然有些电影化的处理和文学创作，但大体上很贴近奥利弗·萨克斯的书。再说一次，这是非虚构作品——萨克斯是位神经学家，或者说他曾是位伟大的神经学家兼作家。据我所知，他并没有过多进行文学加工。

So, yeah. So, Awakenings actually is pretty faithful in a lot of ways. I mean, there's a lot of movie stuff, literary license in there, but for the most part, it's pretty faithful to Oliver Sacks' book. And again, it's non fiction, like Sacks is a neurologist, or he was a great neurologist and a great writer too. So he didn't take a lot of literary license as far as I understand.

因此电影贴近原著意味着电影相当接近现实生活。奥利弗·萨克斯进行的其中一项测试是，他证明了这些患者展现出所谓的‘矛盾运动症’——即那些看似无法动弹、数日数月甚至更久未被移动过的人，嗯哼，却能突然做出本不可能完成的动作。他在电影中演示的方式（我相信书中也是如此），就是朝他们抛出一个球。嗯哼。

So the movie being close to the book means the movie was fairly close to real life. And one of the tests that Oliver Sachs conducted was he would demonstrate that these people were were had demonstrated what's called paradoxical kinesia, where somebody who seemingly can't move and hasn't moved for days, months, however long it was since the last time somebody moved them Mhmm. Could suddenly move in a way that they just should not be able to. And the way that he demonstrates it in the movie, and I believe in the book he did this too, was he would toss them a ball. Mhmm.

突然间，某个双手悬空、面部如凝固面具般毫无表情的人，会在不转动眼球的情况下突然抬手接住球。我认为这至少是电影里（我没读过原著）他在布朗克斯工作的慢性病医院识别患者的方式——通过寻找符合这些症状的对象然后朝他们抛球。有个非常可爱的桥段：他对某人这样做时，球砸中了对方的脸，那人喊道‘哎哟，你干嘛？’显然她并未患嗜睡性脑炎。这场景相当有趣。

And all of a sudden, somebody who's just sitting there with their hands in the air and their face frozen in this mask, this expressionless mask, just suddenly moves their hand without even moving their eyes and catches the ball. And that was, I think, again, at least in the movie, I haven't read the book, how he identified people in this, what they call the chronic hospital that he worked at in the Bronx by by finding somebody who kind of fit these these symptoms, and then tossing a ball at them. And there's a very cute funny part where he does it to one person, and she gets hit in the face and is like, ow, why'd you do that? And she clearly didn't have encephalitis lethargica. It's pretty cute.

几分钟前听起来你说的是‘奥利弗·性’（Oliver Sex）。

It sounded a couple of minutes ago, like you said, Oliver Sex.

我知道。但我没纠正自己。不过你能注意到这点，真不愧是对话分析大师啊。

I know. And I didn't correct myself. You're an all time great conversation analyst though for noticing that.

呃，我是说...那完全是另一部电影了。

Well, just I mean, that's a different movie altogether.

全面涉性。

All over sex.

是啊。那片子也叫《无语问苍天》，所以...

Yeah. Also called Awakening, so.

天啊，那是几分钟前的事吗？我一直在说话，说了这么多吗？

God, was that a couple minutes ago? I've been have I been talking that much?

哦，我对时间没概念。可能才过了十秒钟。

Oh, I have no sense of time. It might have been ten seconds.

太棒了，查克。你最近的笑话真是绝了。

That was amazing, Chuck. You've been killing it with the jokes lately.

哦，谢谢。你提到的其中一点是，他们可能会接球之类的。另一种情况是，他说如果发生紧急情况，比如另一个病人摔倒在地，之前几天、几周甚至几个月都没动过的人，可能会突然从轮椅上跳起来帮忙，然后坐回去恢复雕像般的姿势。你所说的这种现象，正是PEP与帕金森病的关键区别所在，称为矛盾性运动障碍，即在活动与静止之间切换，这通常不会发生在帕金森病中。

Oh, thanks. One of the things you mentioned there is like, they could catch a ball or something. Another thing that would happen, he said that if there was an emergency, like another patient falls on the floor, all of a sudden somebody who previously has not moved for days or weeks or months might just leap up out of their wheelchair and assist them, and then sit back down and go back to their statue pose. And that phenomenon that you're talking about is that's the big key difference between PEP and Parkinson's disease, is called kinesia paradoxical, where you're switching, you know, between mobility and immobility, and that is not something that happens generally in Parkinson's.

不。但我看到它确实有一些，所以是的。是的。但我认为大多数情况下，它更多与慢性昏睡性脑炎相关。对吧？

No. But I saw that it does some, so Yeah. Yeah. But I think for the most part, it's more associated with chronic encephalitis lethargica. Right?

是的。所以最初的事情，这种神秘的昏睡性脑炎疾病在1915、16年突然凭空出现，肆虐全球十年，然后消失了。就像你说的，让整整一代神经学家免于解释它是什么。他们真的努力过。像冯·埃科诺莫这样的人真的试图弄清楚。

Yeah. So this original thing, this where this disease, this mysterious disease encephalitis lethargica suddenly appeared out of nowhere in nineteen fifteen, sixteen, ravaged the world for ten years, and then just vanished. And like you said, let a whole generation of neurologists off the hook for having to explain what it was. Like, they they really tried. Like, people like Von Economo really tried to figure this out.

我想在这次疫情中写了9000篇论文。

I think 9,000 papers were written during this epidemic.

是啊。

Yeah.

他们确实能锁定一些线索，但那些最重大的问题始终没有答案。比如，我们至今仍不清楚，这种可怕的疾病究竟是如何传染的？

And there were some things that they kind of were able to to pin down, but the big, big questions were just left unanswered. Like, we just don't know. Like, one of the big ones is, how do you even catch this terrible disease?

没错。它到底有没有传染性？研究结束时他们仍无定论。关于传播途径的证据非常矛盾。有几个案例恰好能说明这种矛盾性。

Yeah. Like, is it contagious or not? They still didn't have a definitive answer at the end of their their study on that. Evidence on transmission was really really mixed. There were a couple of anecdotal cases that kind of illustrate that.

其中一个案例是住在小公寓里的七口之家，只有一人患病。另一个案例中，德比郡救援训练所的一名女孩出现EL症状后，短短两周内，二十一名住客中有十二人发病。你看，一个案例明显具有传染性，另一个却完全不像。所以他们无法得出结论。

One of them that was among seven members of the family in a small apartment, only one family member got sick. Another case, there was a girl living at something called the Derby and Derbyshire Rescue and Training Home showed signs of EL, and then very soon, within two weeks, twelve of the twenty one residents got sick. So, know, both cases, like one looks clearly contagious. The other one doesn't look like it's at all contagious. So they didn't know.

或许他们认为某些人具有免疫力，或许存在传染性不同的毒株，又或许这根本就是个未解之谜。

Maybe they thought some people might be immune, maybe there were different strains that were contagious, or had different levels of contagiousness, or maybe it's just something that they never figured out.

对。我还在想，那个救助站二十一人中十二人发病的情况，会不会是集体癔症之类的现象

Yeah. And I was wondering too if the twelve of the twenty one residents getting sick at that one home was maybe just a case of mass hysteria or something

有意思的推测。

like that. Interesting.

是的。不。我认为患病的人中有一半在发病后十天内死亡。所以他们不是...是的。那不是集体癔症。

Yeah. No. I think half of the people who got sick died within ten days of falling ill. So they were not Yeah. That was not mass hysteria.

所以这真是个未解之谜，对吧？就像，这完全说不通。于是他们开始尝试排除他们认为不可能的假设。首先考虑的是环境因素，那可能是毒性脑炎。

So that is just a genuine mystery, right? Like, this just doesn't make any kind of sense whatsoever. So they started trying to rule out things they thought it wasn't. Right. One was environmental causes, so that would make it toxic encephalitis.

我甚至不确定我们最初是否提到过——你知道脑炎是指大脑和脊髓肿胀吗？

And I don't even know if we said at the outset, did did you think that encephalitis is swelling of the brain and spinal cord?

哦，不。好吧。我并没有否认。

Oh, no. Okay. I didn't say no.

这就够了。我相信大家都明白脑炎是种可怕的病症。具体来说，它是大脑和/或脊髓发生肿胀，可能开始积水，由此引发各种严重后果。

Good enough. I'm sure everybody got like a pretty good idea that encephalitis is something bad that you don't want to have. Right. But what it is, is a condition where your brain and or your spinal cord swells, and it can start taking on water. And from doing that, all sorts of terrible things can happen.

关键在于，脑炎不仅限于昏睡性脑炎。许多因素都会导致大脑和中枢神经系统肿胀——仔细想想，实际上多得令人不安，其中就包括环境毒素（即毒性脑炎）。这条假设很快被排除了，因为根本不存在所有人接触过某种特定毒素的模式，比如对我们这些科幻迷来说，像是由氪石制成的超立方体之类的东西。

The thing is, is encephalitis is not just specific to encephalitis lethargica. A lot of different things can make your brain and central nervous system swell. A disturbing amount of things can make that happen actually if you stop and think about it, and one of those things is environmental toxins. So that's toxic encephalitis, and that got ruled out very quickly because there just was no pattern whatsoever where everybody was exposed to, you know, like a tesseract made of kryptonite or something like that for our our nerd fans.

没错。这个比喻很棒。

Yeah. That was good.

我本想给你们点甜头，结果彻底搞砸了，所以很抱歉。我

I tried to toss you guys bone and just screwed it up royally, so I'm sorry. I

觉得挺好的。

thought it good.

我可能把DC和漫威搞混了，确实。是的。

I think I may have just conflated DC and Marvel and yeah. Yeah.

Disrakt是漫威的角色。

Disrakt is Marvel.

哦，完蛋了，老兄。

Oh, dead, dude.

不，我喜欢这样。兄弟，你这角色该领便当了。你应该把这两个宇宙融合起来。

No. I love it. I love it, man. You get killed. You should meld those.

超人对战灭霸。当然想看了，我巴不得看他们干架。

Superman meets Thanos. Sure. I wanna see those dudes fight.

哦，那太棒了。我确信那将是一场非常有趣的战斗值得一看。

Oh, that'd be great. I'm I'm sure that would be a really interesting fight to watch.

有人会写信来说，实际上是的，这事发生在1987年，当时你

Somebody's gonna write in and say, actually, yes, it happened in 1987 when, you

知道，某个

know, some

家伙出版了一本漫画。

dude put out a comic.

我怀疑那些人不会再和我们说话了。

I suspect that those people aren't gonna speak to us any longer.

我想你是对的。所以，就像你说的，他们排除了毒性暴露的可能性。然后他们转向了感染性的可能性。实际上是感染性脑炎。要知道，感染性脑炎确实存在。

I think you're right. So, like you said, they ruled that out, the toxic exposure. Then they moved on to an infectious kind of possibility. Infectious encephalitis, in fact. And that can be, know, infectious encephalitis is a thing.

所以我们并不是认为就是那个原因。那已经是已知的情况了。它可能是继发于细菌、真菌、病毒或寄生虫感染。

So it's not like we're we think it's that. That was already a thing. It can be secondary to bacterial or fungal or viral or parasitic infection.

没错。

Right.

通常是由病毒引起的，这是脑炎最常见的类型。可能是疱疹病毒、麻疹，甚至是西尼罗河病毒或流感病毒。考虑到这最初是在1918年西班牙流感期间发生的，当时出现了类似流感的症状，人们认为至少在早期，这很可能是一种由流感引发的感染性脑炎。

It's usually a virus. It's the most common type of encephalitis. It could be like from the herpes virus or maybe measles or West Nile even, influenza. And considering how this went on during the Spanish flu initially, which happened in 1918, and there were flu like symptoms, they thought that, you know, this probably, early on at least, was an influenza led infectious encephalitis.

是的。我想，冯·埃科诺莫的主导理论很有道理，因为正如你所说，至少在初期，它们相互关联。那么，这是否只是西班牙流感的一种可怕变种，能够在西班牙流感之后持续多年？我认为这一点已被无可辩驳地证明是错误的，因为实际上，在我制作《世界末日》时，曾谈到一个人挖出了一位因西班牙流感去世的因纽特妇女的尸体，以获取足够的基因组来复活西班牙流感进行研究。这是科学史上最令人震惊的傲慢行为之一。

Yeah. And that was, I think, Von Economo's leading theory, makes a lot of sense because they tracked with one another, like you said, at least the start. So was this just some horrible strain of Spanish flu that managed to continue on for years after Spanish flu? And I think that was incontrovertibly proven incorrect because actually, in when I did the end of the world, talked about this guy who went up and dug up the corpse of an Inuit woman who had died from Spanish flu to get enough of the genome of it to bring the Spanish flu back to life to study it. It's one of the most breathtakingly arrogant moments in all of science for somebody to do that.

但我们知道昏睡性脑炎并非由西班牙流感引起的原因在于，我们掌握了西班牙流感的基因组，但在那些明确死于昏睡性脑炎的患者脑组织样本中，找不到任何西班牙流感RNA。西班牙流感不存在于其中，因此，它不是西班牙流感。

But the reason we know that encephalitis lethargica wasn't caused by the Spanish flu is because we had the Spanish flu genome, and we couldn't find any Spanish flu RNA in, like, collections of tissue samples of brains of people who definitely died from encephalitis lethargica. Spanish flu wasn't there, ergo, it wasn't Spanish flu.

因为乔什总是太谦虚不愿提起，在提到《世界末日》之后，大家可能不知道，乔什有一张很棒的个人专辑。是八部分还是十部分来着？

And because Josh is always too humble to say so, after an end of the world reference, everyone, if you don't know, Josh had a great solo album. A eight part or 10 part?

是十部分，副标题为《蜡样屈曲》。

It was a 10 part subtitled Waxy Flexibility.

《乔什·克拉克的世界末日》，他每期节目探讨十个——我一时想不起这个词——存在性风险，这些风险可能威胁人类，其中一些目前正在进行中。

The End of the World with Josh Clark, where and he, one episode at a time, examined 10 I can't think of the word. Existential. Risks that could face humanity, some of which are currently underway.

非常感谢，查克。我很感激。你真是太好了。是啊，你并没有

Thanks a lot, Chuck. I appreciate that. That was really nice of you. Yeah. You didn't

意思是你得是个聪明人。但即使你不是聪明人，也应该尝试一下，思考一下。因为我试过了，我可不是什么聪明人。

mean You gotta be a smarty pants. But even if you're not a smarty pants, you should still give it a shot, think. Because I I gave it a shot, I'm not a smarty pants.

嘿，你就是个聪明人。不过话说回来，无论是不是聪明人，我觉得大家都会被这个吓到。

Hey. You are a smarty pants, but yes, smarty pants or no, I think everybody can be equally scared by this.

没错。你也做过现场演出，所以如果你手上有台时光机，不妨回去看看其中一场。

Yeah. You did live shows too, so if you have a time machine on your hands, go back and see one of those while you're at

要是你真有一台能用的时光机，也来跟我们聊聊。那可就太酷了。

it. And come talk to us if you have an actual working time machine as well. That'd be pretty neat.

链球菌感染曾是另一个可能的病因。有数据显示，在某些EL病例前存在链球菌感染。1931年，我们的老朋友伊万·伊科诺莫医生做了个实验，结果链球菌疫苗竟导致狗出现了类似EL的症状。

Streptococcal infection was another possibility at one point. There was some data that showed infection with streptococcal bacteria was in front of some of these cases of EL. And in 1931, our old pal, doctor Ivan Ikonomo, did an experiment, and streptococcus vaccination actually led to EL, an EL like condition in dogs.

是啊，虽然很遗憾，但

Yeah. Which is sad, but

是啊。

Yeah.

问题是，更令人难过的是当时并没有确诊。他们并没有明确说，哦，这是链球菌感染。

The thing is, the thing that makes it even more sad is it wasn't definitive. They weren't like, oh, it's a strep infection.

没错。

Right.

当时的情况更像是，可能是吧。还有个叫马西森委员会的团体研究过昏睡性脑炎，因为有个据说是姓马西森的人——我查不到具体是谁——他是个美国富商，染上了昏睡性脑炎。我记得他后来好转了，但没完全康复。于是他出资试图查明病因，资助这个委员会长达十三年。

It was like, I guess it could have been. There was another group called the Matheson Commission that studied encephalitis lethargica because a guy, ostensibly by the last name of Matheson, I couldn't find Yeah. Who it He was a wealthy businessman from America who had been struck down by encephalitis lethargica. I believe he had gotten better, but not fully. And so he used some money to try to get to the bottom of this and funded this commission for thirteen years.

他们发布了四份不同的报告，最后基本上就说：可能是疱疹？我们也不确定。然后他说，资金断供。我现在加入了福尔摩斯协会，那才是我要资助的对象。

They put out four different reports and basically at the end said, maybe herpes? We don't know. And he said, your funding's cut off. I've gotten into Sherlock Holmes societies. That's who I'm funding now.

花了那么多钱这么多年，最后就得出个‘可能是疱疹’？开什么玩笑？至少...

At the end of all that dough for that many years, you come back with maybe herpes? Are you kidding me? The very least,

干脆也给我传染疱疹算了。这让我想起小时候，我永远忘不了第一次真正记住的新闻标题——因为那时候我有点迷《谁是老板》。好吧，肯定是《国家询问报》之类的，标题是‘托尼·丹扎传染给我疱疹’。我昨天还特意查了托尼·丹扎到底有没有传染过别人疱疹，结果好像根本没这回事。

give me herpes too. That reminds me, when I was a kid, I'll never forget, one of the first headlines that ever sunk in with me, because I was a Who's the Boss fan a little bit at the time. Okay. It was a it had to be the Enquirer or something, but it was Tony Danza gave me herpes. And I looked, like, just yesterday to see if Tony Danza actually had ever given anyone herpes, and it does not seem to be the case.

我不相信托尼·丹扎会得疱疹。所以那个标题完全是捏造的。我希望托尼·丹扎能因此起诉《问询报》并获得赔偿。

I don't believe Tony Danza has herpes. So that headline was totally made up. I hope Tony Danza got some money from that for suing the Enquirer.

是啊。哦，我们也应该发布更正。你把托尼·丹扎乐队名字搞错了。

Yeah. Oh, we should issue that correction too. You got that Tony Danza band name wrong

哦，是吗。

Oh, did.

在重金属专题那几期里。

In the metal episodes.

那你知道正确的名字是什么吗？

Well, do you know what the correct one was?

呃，你当时是怎么称呼它的来着？

Well, what do you what did you call it?

我记得我称之为'托尼·丹扎踢踏舞体验'。难道不对吗？

I think I called it the Tony Danza Tap Dance Experience. Is that not it?

我想如果你说的是那个，那应该是《踢踏舞盛宴》。

I think if that's what you said, I think it was Tap Dance Extravaganza.

哦，好吧。

Oh, okay.

或者正好相反。无论你说的是哪个，都是错的。

Or it's the other way around. Whichever one you said was wrong.

没关系，我能接受。

That's fine. I can live with that.

是啊是啊。有几个金属乐迷写信来指出这个问题。所以，你知道，不能不纠正《托尼舞与达普舞盛宴》这个错误。

Yeah. Yeah. We had a few metal people write in about that. So, can't, you know, can't not correct the Tony Dance and Dap Dance Extravaganza.

但我打赌他们态度都很好，基本上每个人都是这样。所有写信来的金属乐迷

I'll bet they were nice though, like, to a person, pretty much. All the the metal fans that wrote in

没错。

Yeah.

是啊。他们说，连纠正我们的人都说，那太棒了。没错。

Yeah. Said, even the ones correcting us were like, that was great. Yeah.

这就是金属风格。确实如此。好吧，我们该休息一下了吗？好的。

That's the metal way. It is. Alright. Shall we take our other break? Yeah.

当然。

Sure.

好的，我们马上回来。

Alright. We'll be right back.

等等。

Wait.

你对资金的去向深思熟虑。你有核心持仓，定期买入加密货币，甚至可能还有一些策略性的期权操作。关键在于你积极参与投资，而Public理解这一点。因此他们为认真对待投资的人打造了这个平台。在Public上，你可以构建一个多元资产的长期投资组合。

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所有投资均存在亏损风险，包括本金损失。美国上市注册证券、期权、债券的自助账户经纪服务由Public Investing Inc.提供，该公司为Finrun SIPC成员。加密货币交易由Bakkt Crypto Solutions LLC提供。完整披露信息请访问public.com/disclosure。

All investing involves the risk of loss, including loss of principal. Brokerage services for US listed registered securities, options, bonds in a self directed account are offered by Public Investing Inc. Member Finrun SIPC. Crypto trading provided by Bakkt Crypto Solutions LLC. Complete disclosures available at public.com/disclosure.

生活难免杂乱——泼洒、污渍、宠物和孩子。但有了Anabay，你再也不必为脏乱烦恼。登录washablesofas.com，发现Anabay沙发，唯一内外全机洗的沙发，起价仅699美元。采用防液体防污渍面料制成。

Life's messy. We're talking spills, stains, pets, and kids. But with Anabay, you never have to stress about messes again. At washablesofas.com, discover Anabay sofas, the only fully machine washable sofas inside and out, starting at just $699. Made with liquid and stain resistant fabrics.

这意味着更少污渍，更多安心。为真实生活设计，我们的沙发配备可更换布套，让你随时焕新风格。需要灵活性？模块化设计让你轻松重组沙发，完美适配温馨公寓或宽敞住宅。此外，它们环保耐用。

That means fewer stains and more peace of mind. Designed for real life, our sofas feature changeable fabric covers, allowing you to refresh your style anytime. Need flexibility? Our modular design lets you rearrange your sofa effortlessly, perfect for cozy apartments or spacious homes. Plus, they're earth friendly and built to last.

这就是为什么超过20万满意顾客选择了我们。立即升级你的生活空间，访问washablesofas.com，带回家一款为生活而生的沙发。网址washable.com。优惠可能变更，部分限制适用。

That's why over 200,000 happy customers have made the switch. Upgrade your space today. Visit washablesofas.com now and bring home a sofa made for life. That's washable.com. Offers are subject to change and certain restrictions may apply.

但认识到生活是我们永远不应毕业的课堂，这种谦卑将让你持续成长——这才是最重要的。世界心理健康日即将到来。在我的播客《Just Heal with Doctor.J》中，我深入探讨了真正照顾身心灵的含义。从打破代际模式到建立情感能力，治愈是旅程，完整是终点。

But the humility in knowing that life is this classroom that we should never graduate from is what is going to keep you growing, and that's all that matters. World Mental Health Day is around the corner. And on my podcast, Just Heal with Doctor. J, I dive into what it really means to care for your mind, body, and spirit. From breaking generational patterns to building emotional capacity, healing is a journey and wholeness is the destination.

我将带着深深的治愈感离开，并坚信：是的，我会继续我的治愈之旅。

I'm gonna walk away feeling very healed and feeling like, yes, I'm gonna continue my healing journey,

而我

and I

我要从你这儿拿些钥匙。

I'm gonna get some keys from you.

请在iHeartRadio应用、Apple Podcasts或任何你获取播客的平台，收听Black Effect播客网络的Jess Hill与Doctor J的节目。

Listen to Jess Hill with doctor j from the Black Effect Podcast Network on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

好的。我们提到过以前有些人研究过各种病因，如你所知，他们始终未能发现什么，正如我们所说。大约三十年间，他们就那样搁置了。直到1960年代末，研究帕金森症的神经学专家们才真正取得突破，他们开发了L-DOPA（左旋多巴），这是一种多巴胺替代物——帕金森患者缺失的神经递质。

Alright. So we mentioned some people studying, you know, different causes back in the day. They never could find anything out, like we said. And for about thirty years, they just kinda left it there. And it was in the late nineteen sixties when neurology researchers that were working on Parkinson's really hit on it when they developed L DOPA or levodopa, which is a substitute for dopamine, which is the missing neurotransmitter

嗯。

Mhmm.

在帕金森病中。这种药物于1967年问世，让运动不能型帕金森患者重获新生。如果你看过电影《无语问苍天》，那基本上就是主线剧情。故事就是从奥利弗·萨克斯搞到一些L-DOPA开始的。

In Parkinson's disease. And it was released in 1967, and it brought akinetic Parkinson's disease patients back to life. And if you've seen the movie Awakenings, that's basically a big story line. That's where it picks up is when Oliver Sacks scores some L DOPA.

没错。他从贝斯·亚伯拉罕医院楼下街角兜售药品的人那儿弄来的。

He did. Off a guy selling it on the corner below Beth Abraham Hospital.

正是如此。

Exactly.

是的。于是，他最终从伦纳德·洛（罗伯特·德尼罗饰演，显然不是患者真名）开始讲述，这些如冰冻雕像般生活了数十年的病人突然发生了惊人的转变——他们恢复了意识、能够交谈、将注意力集中在你身上。有人弹起了钢琴，他们甚至开始外出郊游。仿佛被彻底唤醒。而现实中帕金森病患者对左旋多巴药物的反应据说也是如此显著。

Yeah. So, he finally starts with Leonard Lowe, who's Robert De Niro, not the patient's real name obviously, but there's just this amazing transformation where all of a sudden, these people again who are these frozen statue like people and have been for decades of their lives suddenly, like, are, like, aware and talking and, like, focusing their attention on you. And one guy's playing the piano and they're like going out on field trips now. It's like they were just completely broad out And of that supposedly was very much the case with people with actual Parkinson's disease. Like they responded beautifully to L DOPA.

但脑炎后帕金森症与帕金森病不同的一个关键指标在于：《苏醒》中那些脑炎后遗症患者初期对药物反应良好，但随后出现其他症状，导致部分人不得不停用左旋多巴。最令人心碎的是，他们被迫重新回到冰冻雕像般的状态。别忘了，在这种状态下他们仍保有高度意识——他们曾从清醒状态中完全苏醒，能自由互动甚至出院郊游，最终却要带着完整记忆再次回到动弹不得的躯壳中。

But one of the reasons, one of the indicators that post encephalitic parkinsonism and parkinson's disease are different is that the people in awakenings, the people with encephalitis lethargica, they responded well for a little while, and then they started to show other symptoms that really kind of for some of them, it basically meant you can't take L dopa anymore, and incredibly sadly, like one of the most sad things I can think of, they were left to just go back to their frozen statue state again. And don't forget, there is a great level of consciousness within them when they're in this So they came out of that state in which they were conscious, came to full consciousness and full interactivity, and maybe even left the hospital on a field trip, and then had to go back to their frozen statue state again, conscious of this whole experience.

没错。电影里有个特别令人心碎的案例，就是那个你私下跟我提过的叫罗丝的女人？

Yeah. Very heartbreaking to see in that movie. There was one case of a woman who is this the Rose of which you spoke of to me privately?

对，那是罗丝。不过在电影里她叫露西，不知为何改了名字。

Yeah. That was Rose. And then Lucy was her name in the movie for some reason.

明白了。这位奥利弗·萨克斯笔下的患者苏醒后描述说，过去几十年里她其实清楚感知着周围一切，却感觉与外界存在诡异的割裂感。她知道珍珠港事件...

Okay. Well, this woman, just one of the cases of Oliver Sacks, she she came out of it. And she basically described like being aware of everything that was happening for decades and understanding what was happening, but just not feeling a connection to it. Like, there was this weird disconnect. She she knew about Pearl Harbor.

她描述自己知晓肯尼迪（约翰·F）遇刺案，但感觉都不真实。她说：'自1926年患上脑炎陷入停滞以来，一切都像幻觉。我知道现在是1969年，自己64岁，是个困在慢性病医院的古怪老妇人——可我感觉仍是21岁，仿佛活在1926年。'

She described knowing about the assassination of Kennedy. John F, that is. And she said that it just didn't seem real. She said nothing has seemed real since 1926 when I got the encephalitis and came to a stop. I know I'm 64 now, and that this is 1969, and that I'm an elderly woman in a bizarre situation in a chronic hospital, but I feel like I'm 21, and I feel like it's 1926.

天啊，你能想象这种感受吗？

Yeah. Man, can you imagine?

是的，非常遗憾的是，她是那些因服用左旋多巴症状过于极端而无法继续用药的患者之一。

Yeah, and very sadly, she was one of the ones who did not, like have her symptoms with L dopa were too extreme to continue on taking L dopa.

没错。有些人，你知道，走出来时对这种变化欣喜若狂，显然非常激动。而另一些人走出来时，明显能看出他们因失去的几十年而备受煎熬。无论哪种情况，接受现实都不容易。电影里还是有好消息的。

Yeah. And some people, you know, came out and were just overjoyed and elated with this kind of thing, obviously. And some people came out and, obviously, you could also see, had a very hard time with lost decades. It could not have been an easy thing to accept either way. The movie there is good news.

还是有一线希望的，因为电影没有提及的是，此后许多患者通过左旋多巴治疗最终稳定下来，至少能过上比之前相对健康的生活。他们不再处于那种僵直无反应的状态，虽然未必完全康复，但生活还算过得去。

There is a bit of a silver lining because the movie does not cover the fact that after this, a lot of the patients finally regulated with the L DOPA and were able to leave at least lead, compared to sort of their previous life, a somewhat healthy life. Like, they weren't in that statuesque locked in state. They might not have fully recovered, but they they led an okay life.

对。是的。他们在结尾的某个后记或尾声部分提到了这一点。

Right. Yeah. And they do mention that at the end in one of those, I guess Postscript. Epilogues. Postscripts.

是的。那里讲到他们如何继续实验，对有些人效果还不错。但电影里没展现这些，结局全是悲伤的。是啊。

Yeah. Where they talk about how they continued on experimenting, and some people it kinda worked out with a little bit. So but they don't they don't show it in the movie. The movie's all sad at the end. Yeah.

太令人难过了。确实。天啊。快再去看看《无语问苍天》吧。

It's so sad. It is. And yeah. Oh my god. Just go watch Awakenings again.

我甚至先误看了《心灵点滴》，当时特别想看《无语问苍天》，结果看完《心灵点滴》和《超级名模》后，终于看了《无语问苍天》。昨晚一直熬到凌晨四点。

Even watched I accidentally watched Patch Adams first, and I wanted to watch Awakenings so bad, I still watched it after Patch Adams, after Zoolander, and then I finally watched Awakenings. I was up till like four in the morning today, last night.

我从未看过《心灵点滴》。

I never never saw Patch Adams.

哦，那可不太好。

Oh, it's not good.

但那也算是性爱场景吧？不对。

That was sex too though, right? No.

那只是罗宾·威廉姆斯的独角戏。就是

It was just Robin Williams too. It was

哦，我

Oh, I

估计不是《无语问苍天》。我可以肯定地告诉你。

guess it no awakenings. I'll tell you that.

是啊。我得去看看那部片子。有意思的是，多年前我遇到过一个叫伦纳德·洛的人，当时我脑子里唯一想的就是，我的名字是伦纳德·洛。对。就像我记得德尼罗说的那句台词。

Yeah. I need to check that out. It's funny, I met a guy named Leonard Lowe one time years ago, and the only thing I could think in my head was, my name is Leonard Lowe. Yeah. Like I just remember De Niro saying that.

你没跟他说过这话吗？

Did you didn't say that to him?

没有。因为我觉得，就像我们的听众罗伯特·保尔森，他可能已经听腻了那些玩笑。

No. Because I figured, you know, like our our listener Robert Paulson, he's probably tired of those jokes.

我从没停止对罗伯特·保尔森说这个，我控制不住自己。

I never stopped saying that to Robert Paulson, I can't help myself.

那现在呢？从医学角度，我们怎么看待EL？

So what about these days, what do we think about EL, medically speaking?

我们发现但至今仍未完全理解的一点是——其实在L-多巴疗法之前，研究者观察患者时就注意到：当人处于这种冻结状态时，就像我之前说的，如果有人朝你扔球，或者像你说的遇到紧急情况，他们能突然像正常人一样行动，之后又恢复冻结状态。他们发现不仅是紧急情况，比如球飞过来或朋友摔倒，像音乐、人体接触，甚至是警笛这类刺耳声音，都能刺激患者重新开始活动，从运动不能或缄默状态中恢复过来。嗯。这也是L-多巴治疗中观察到的现象——即便患者有严重震颤或无法控制口眼运动，通过其他方式刺激大脑也能缓解症状。有个故事讲一位患病前做鞋匠的人...

Well, so one of the things that we did learn that we still don't fully understand, but was something that they recognized with L DOPA, and the study of the patients before they were administered L DOPA is that while you're in this frozen state, like I said earlier, somebody throws a ball at you, or like you said, somebody sees an emergency, they can suddenly move like normal, and then they go back to that frozen state afterward. They found that it's not just like an emergency, like a ball coming at you or your friend laying on the floor because they fell down, but things like music, human touch, even obnoxious sounds like a siren or something, can basically prompt the person to start moving again, and come back out of that frozen ketonia or mutism. Uh-huh. And that was one of the things that they found people could do on L dopa too, like even with the extreme tremors or inability to control the movement of your mouth or eyes, those could be tamed by the same thing, stimulating your brain in some other way. And there was the story of a guy who was a cobbler by trade before he had gotten sick.

哦，对。

Oh, yeah.

L-多巴问世后，他要求医院给他弄个修鞋工作台。当他专注修鞋时，竟能用牙齿叼住小钉子给鞋跟钉钉，症状完全受控。这说明大脑有某种机制能压制症状。我们不知道原理，只知道这是整体现象的一部分——某些脑区能优先接管控制权覆盖这些症状，这太诡异了。从头到尾，这简直是史上最诡异的疾病。

And after L dopa came along, he asked for like a cobbler's bench, the hospital staff got him one, and when he was working in his cobbler's bench, was able to like, hold, like, nails in his teeth and, like, nail the heel of the shoe with these little tiny nails and just work and control the symptoms because there's something in the brain that was overriding the symptoms. We have no idea why. We just know that that was part of this whole thing. There's some some way that the the these problematic symptoms can be overridden by some other region of the brain taking importance or precedence over that, which is just bizarre. Like, from start to finish, this is one of the most bizarre diseases in history.

是啊，是啊，当然。你也是偶然看了《震颤》吗？

Yeah. Yeah. For sure. Did you also watch Tremors by accident?

没有。那本该是很愉快的。那是我最喜欢的电影之一。

No. That would have been very pleasant. That's one of my favorite movies.

突然间，太阳升起来了，而你还没看过《无语问苍天》。

All of a sudden, the sun's coming up, and you still haven't seen Awakenings.

对。所以，

Right. So,

回到现代视角和我们如今的医学认知，正如我所说，过去七十五年间它几乎消失了，他们也不太清楚。这七十五年来，只有大约80例病例报告看起来可能是EL。嗯，他们称之为类似EL的表现。你知道的，那种过度嗜睡，可能伴有眼肌麻痹，也许还有一些神经精神症状。

getting back to the modern perspectives and what we think medically these days, in the last seventy five years, like I said it completely went away, they kinda don't know. In the last seventy five years, there's only been about 80 case reports where it looks like it might be EL. Mhmm. They call it like an EL like presentation. You know, the the hypersomnolence, maybe ocular paralysis, maybe some of those neuropsychiatric symptoms.

但他们并不十分确定，因为这些病例差异很大，症状也各不相同。再说，他们手头只有从前那些病例研究。从未得出确切结论，所以很难判断这种情况是否还在发生。目前也没有特效疗法。你知道，他们仍然在使用左旋多巴。

But they're really not sure because the cases are pretty varied and the symptoms are pretty varied. And again, all they have is sort of these case studies from before. They never landed on anything, so it's hard to tell if this is still going on at all or not. There's no like effective treatment. You know, they still use L DOPA, think.

对吧？是的。那个药还在用吗？嗯。是的。

Right? Yeah. And that's still on the scene? Mhmm. Yeah.

所以对于震颤、僵硬这类症状，有时会采用电休克疗法，如果你有非常严重的精神症状的话。至于冯·埃科诺莫的研究，他从未获奖，但曾三次获得诺贝尔奖提名。相当了不起。

So for the tremors and rigidity and stuff like that, sometimes ECT for if you have, like, pretty extreme psychiatric symptoms. But for Von Economo's work, he got he never won, but he was nominated three times for a Nobel Prize. Pretty good.

确实如此。而且别忘了，他最初也怀疑这是某种感染。是的。他以为西班牙流感不是西班牙流感，但现在人们认为它很可能是由感染引发的自身免疫性疾病的结果。

Yeah. For sure. And remember, he also originally suspected that it was some sort of infection. Yeah. He thought Spanish flu wasn't Spanish flu, but they do think that it's probable now that it is the result of an autoimmune disorder triggered by an infection.

对。这意味着你可能被链球菌、疱疹病毒或流感病毒感染——具体是哪种尚不明确。但某种与大脑不同区域蛋白质相似的病原体，会诱导你的身体攻击大脑中的这些蛋白质，从而触发自身免疫性疾病。而这些蛋白质仅存在于特定脑区，当你退一步观察这些区域的功能时，会发现它们正好控制着昏睡性脑炎患者表现出的症状。

Yeah. So what that would amount to is that you are infected by, maybe it is strep, maybe it is herpes, maybe it is influenza, we don't know. But something that resembles proteins found in different regions of your brain trains your body to attack those proteins in your brain, so it triggers an autoimmune disorder, and those proteins are only found on specific regions of the brain that when you step back and look at what those regions do, they control the symptoms that you see in people with encephalitis lethargica.

没错。

Right.

我刚才听起来就像《洛基恐怖秀》里的蒂姆·库里。快躺到——

I just sounded like Tim Curry in Rocky Horror Picture Show. Get up on the

解剖台上去。

on the slab.

哦，太棒了。我都忘了你模仿弗兰肯福特医生有多传神。

Oh, that was good. I forgot how good your impression is of doctor Frankenfurter.

哦，好吧，你知道，我见过那个人。他抱了我的猫。哦，没错。

Oh, well, you know, I met the man. He held my cat. Oh, that's right.

他说你的猫很淘气。对吧？

He said your cat was naughty. Right?

他说它的耳朵很戏剧性。

He said he had dramatic ears.

哦，好吧。是的。不过也很淘气。

Oh, okay. Yeah. But also naughty.

是啊是啊，淘气。躺到台子上去，Laurent。我没什么可说的了。

Yeah. Yeah. Naughty. Get on the slab, Laurent. I got nothing else.

哦，好吧。让我想想。我猜我也没什么可说的了。就这样吧。我们对这一切都没有答案，也不知道什么时候会有。

Oh, okay. Let's see. I guess I got nothing else either. That's it. We don't we don't know the answer to all of this, and I don't know when we ever will.

但这件事如此令人着迷，你不得不停下来提醒自己，这确实发生在人们身上，然后你才意识到整件事有多么可怕。

But it's just it's so fascinating that you have to stop and remind yourself, like, this actually happened to people, and that then you realize how terrifying the whole thing really is.

是啊。

Yeah.

好吧，查克在七秒内说了两次‘是啊’，这意味着，哦，现在他把话题带偏了。你得再说一次‘是啊’，快点。

Well, Chuck said yeah twice within seven seconds, which automatically means, oh, well, now he derailed it. You have to say yeah one more time. Hurry.

是啊。

Yeah.

好的，现在我们回到听众来信环节。

Okay. Now we're back on to listener mail.

乔什，我觉得你会喜欢这个。嘿，伙计们，这是关于A轨道的。我总是能从你们那里学到东西，有时候是意想不到的。在A轨道的短篇内容里，你们提到‘cart’是‘cartridge’的缩写，这让我想起了一些事。

This is you're gonna like this one, Josh, I think. Hey, guys. This is about the A tracks. I always learn something from you, sometimes unexpectedly, you guys. In the A track short stuff, you talked about cart being short for cartridge and sparked a memory.

我来自布法罗，以前常听一个叫铁麦克·本森的电台主持人。他有个著名的说法，杰米说，特别向你道歉，乔什。

I'm from Buffalo, you see, and I used to listen to a radio announcer called Iron Mike Benson. He famously had what he called, and Jamie says, sorry to you specifically, Josh, about this.

好的。

Okay.

迈克·艾恩·迈克·本森会说他有一台可恶的肛门放屁车，他会用它播放各种放屁声，并策略性地将它们叠加在电台当时播放的任何歌曲上。我当时总以为‘车’这个词指的是带轮子的篮子，里面装着一堆单独的磁带。对，就是放屁声的磁带。现在一切都明白了。那是一盘磁带录音，但因为它是循环带且有多条音轨，他能比使用线性盒式磁带更快地调出想要的任何片段。

Where Mike Iron Mike Benson would say that he had the heinous anus fart cart, and he would use it to play various fart sounds and strategically place them over top of over the top of whatever songs happened to be getting played on the air at the moment. I always imagined the word cart at the time was referring to like a basket on wheels that contained a bunch of separate tapes Yeah. Of fart sounds. Now it all makes sense. It was a tape recording, but because it was a looped tape with multiple tracks on it, he could cue whatever selection he wanted much quicker than you could with a linear cassette tape.

所以这是在数字音效板被使用和发明之前，实现这类效果的模拟方式。感谢你提供所有这些‘无用’但引人入胜的信息——顺便说，‘无用’是带引号的。好吧，这些信息只有在你能将其与其他事物联系起来之前才是无用的。播客来来去去，但你们的节目是我一直未曾厌倦的。

So it was the analog way to do that sort of thing before a digital soundboard was used and invented. Thank you for all the useless interest grabbing information, and useless is in quotes, by the way. Okay. That is only useless until you can relate it to something else. Podcasts have come and gone, but your show is the one I haven't gotten tired of.

我妹妹阿什莉也这么认为。继续加油，伙计们。这里是杰米·林恩·贝尔。

And my sister Ashley agrees. Keep it up, boys. That is Jamie Lynn Bear.

太棒了。谢谢你，杰米·林恩，也谢谢你妹妹阿什莉——显然她也在收听，还有整个贝尔家族。怎么样？

Awesome. Thank you, Jamie Lynn, and thank you to your sister Ashley who ostensibly listens as well, and the whole bear clan. How about that?

是啊，洞穴熊家族。

Yeah. The the clan at the cave bear.

我也这么想。没错。如果你想成为《洞穴熊家族》那样，写信告诉我们你有多喜欢我们的节目，或者我们触发了你的某些记忆帮你理清思路，或者任何你想说的话，我们超爱收到这类反馈。你可以通过电子邮件发送至stuffpodcast@iHeartRadio.com。

I thought that as well. Yeah. If you want to be like the clan of the cave bear and write in to let us know how much you like our show and or we triggered some memory in you that helped you put things together and or whatever else you wanna say, we love that kind of thing. You can send it to us via email at stuffpodcast@iHeartRadio.com.

《你应该知道的事》是iHeartRadio出品。想收听更多iHeartRadio播客，请访问iHeartRadio应用、苹果播客或你常听的播客平台。

Stuff You Should Know is a production of iHeartRadio. For more podcasts, My Heart Radio, visit the iHeartRadio app, Apple podcasts, or wherever you listen to your favorite shows.

我只是觉得这个过程和旅程如此美妙。所有精彩的部分都在其中。你不能仅仅以最终结果来评判生活的成败。

I just think the process and the journey is so delicious. That's where all the good stuff is. You just can't live and die by the end result.

这是喜剧演员菲比·罗宾逊说的。没错，这类金句你只能在我的播客《光明面》中听到。我是主持人西蒙娜·博伊斯，我将与娱乐、健康、养生和流行文化领域最杰出的头脑对话。每周，我们都会在社区、事业和自我成长方面展开探索。

That's comedian Phoebe Robinson. And, yeah, those are the kinds of gems you'll only hear on my podcast, the bright side. I'm your host, Simone Boyce. I'm talking to the brightest minds in entertainment, health, wellness, and pop culture. And every week, we're going places, in our communities, our careers, and ourselves.

所以每周一加入我吧，让我们一起寻找光明面。在iHeartRadio应用、Apple播客或任何你获取播客的地方收听《光明面》。

So join me every Monday, and let's find the bright side together. Listen to the bright side on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

互联网是我们创造的产物，而不仅仅是我们被动接受的事物。

The Internet is something we make, not just something that happens to us.

我是布里奇特·托德，科技与文化播客《互联网上没有女孩》的主持人。在新一季中，我将与像阿尼尔·达什这样的先驱企业家兼作家对话，他始终拒绝以 cynical 的态度看待互联网。

I'm Bridget Todd, host of the tech and culture podcast, there are no girls on the Internet. In our new season, I'm talking to people like Anil Dash, an OG entrepreneur and writer who refuses to be cynical about the Internet.

我热爱科技。你知道，

I love tech. You know,

我这辈子都是个书呆子，但总要有个追求的目标。不能只是为了技术而技术。

I've been a nerd my whole life, but it does have to be for something. Like, it's not just for its own sake.

这是一个以人为互联网核心构建模块的励志故事。请在iHeartRadio应用、Apple播客或任何你获取播客的地方收听《互联网上没有女孩》。

It's an inspiring story that focuses on people as the core building blocks of the Internet. Listen to There Are No Girls on the Internet on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

今年早些时候，当费城新生儿KJ成功接受全球首例个性化基因编辑治疗的消息传出时，这标志着研究人员和患者共同迈入了一个里程碑。但这一成就及其创造者背后，还隐藏着一段扣人心弦的探索故事。我是埃文·拉特利夫，与传记作家沃尔特·艾萨克森一起，我们将深入探究诺贝尔奖得主珍妮弗·杜德纳的故事——这位改变了人类命运轨迹的女性。请在iHeartRadio应用、Apple播客或任何你获取播客的地方收听《CRISPR风云录：沃尔特·艾萨克森讲述珍妮弗·杜德纳的故事》。

When news broke earlier this year that baby KJ, a newborn in Philadelphia, had successfully received the world's first personalized gene editing treatment, it represented a milestone for both researchers and patients. But there's a gripping tale of discovery behind this accomplishment and its creators. I'm Evan Ratliff, and together with biographer Walter Isaacson, we're delving into the story of Nobel Prize winner Jennifer Doudna, the woman who's helped change the trajectory of humanity. Listen to On Crisper, the story of Jennifer Doudna with Walter Isaacson on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

这是iHeart出品的播客节目。

This is an iHeart podcast.