昏睡病疫情（1919-1930）

哦，是的。

Oh, yeah.

而且他们就待在那儿。

And they're just on yeah.

他们挤在一起，不停地轮换。

They're on top of each other, and they're all just being, like, switched switched out all the time.

嗯。

Yeah.

有时，医院的整个病区都会专门用于治疗他们。

And the entire wings of hospitals would be dedicated to their treatment at times.

今天我们来谈一种叫嗜睡性脑炎的疾病。

Now we're talking today about a disease that's called encephalitis lethargica.

好的。

Okay.

这种病最初出现在哪里还不清楚。

It's kind of unknown where it first appeared.

二十世纪初的这场流行病被认为始于1915年的罗马尼亚。

The epidemic of the early twentieth century is thought to have started in 1915 Romania.

但关于这种疾病最近的研究认为，它可能类似于一种被称为英国汗症的疾病。

But more recent studies of this disease have thought that like maybe something called the English sweats, it was referred to.

好的。

Okay.

可能和这个类似。

Might have been similar to this.

也许那就是最初对它的认识。

And maybe that was the first thought of it.

就像是看到它之类的。

It's like sight of it or whatever.

但很难准确确定，因为正如我们接下来会看到的，这种病症状多种多样，而且非常奇特。

But it's really hard to pinpoint because as we'll come to see during this, this has so many varying symptoms and they're so weird.

是的。

Yeah.

这些症状很奇怪，从来不会以相同的方式影响两个人。

Like they're strange symptoms and they never It like doesn't hit two people the same way.

好的。

Okay.

真的很奇怪。

It's very strange.

听起来有点像新冠。

Kinda sounds like COVID.

没错。

It is.

真的很可怕。

It's really scary.

现在，这种疾病的首批已记录病例出现在1916年维也纳的冯·埃孔莫斯诊所和巴黎雷内·克鲁歇医生的诊所。

Now, the first documented cases of the disease appeared in 1916 at Von Economos clinic in Vienna and at the Paris clinic of doctor Rene Crucher.

在克鲁歇的诊所，士兵们从前线陆续抵达，表现出各种症状，这些症状很容易识别，但却无法整合成一个明确的诊断。

At Crucher's clinic, men started arriving from the front lines with just a variety of symptoms that they were easily identifiable, but they didn't really comprise together like a single diagnosis.

诊断。

Diagnosis.

好的。

Okay.

单独来看，你可能会想，哦，就是这样。

By themselves, you could be like, okay, that's That's that.

但综合起来，这到底是什么鬼东西？

But altogether, it was like, what the fuck is this?

根据作者莫莉·考尔德韦尔·克罗斯比的说法，有些人发烧，有些人则没有。

According to author Molly Caldwell Crosby, quote, some had fever, others did not.

大多数人抱怨头痛和恶心。

Most complained of headache and nausea.

最奇怪的是这些士兵睡得太多了。

Strangest of all was how much these soldiers slept.

现在，可以理解的是，一个得了流感或类似流感症状的人，比如这些士兵，可能会比健康人需要更长时间的睡眠。

Now, it makes sense that a person who gets, you know, the flu or flu like thing, as these guys were, would probably, you know, want to and need to sleep for longer periods than someone who's healthy.

但这些病人身上有一种非常令人不安的地方。

But there was something like very unnerving about these particular patients.

不仅仅是他们睡觉的时间很长，还有他们的样子。

Not just the amount of time that they were sleeping, but also the way that they looked.

好吧。

Okay.

克罗斯比说，起初看起来几乎很宁静。

Crosby said it would have seemed almost serene at first.

他们面无表情，没有恐惧和痛苦。

Their blank expressionless faces free of terror and pain.

但随着时间推移，他们会陷入沉睡，并持续数日，有时甚至数周。

But over time, they would fall asleep and stay that way for days or sometimes weeks.

这他妈的是怎么回事？

What the fuck?

然后有时候，他们就再也醒不过来了。

And then sometimes they would never wake up.

哦。

Oh.

嗯。

Yeah.

哦。

Oh.

在维也纳，冯·埃孔莫医生也观察到他的病人——这些来自前线的士兵——出现了类似奇怪的症状组合。

Now in Vienna, doctor Von Economo was seeing like a similar strange combination of symptoms in his own patients that were coming from the front lines, like soldiers.

1917年1月，一名男子来到诊所，主诉疲劳、困惑和头痛。

In January 1917, a man arrived at the clinic complaining of exhaustion, confusion and headaches.

他坐在医生面前，说当他坐在医生面前时，他不仅难以保持坐姿，甚至连保持清醒都很困难。

And he sat in front of the doctor and he said that he was like as he sat in front of him, he was struggling not just to stay upright, but just to stay awake.

他根本无法保持清醒来和医生交谈。

He, like, couldn't even stay awake to sit and talk to him.

哇。

Wow.

他瘫坐在椅子上。

He slumped in his chair.

他的头左右晃动。

His head was like lolling around from side to side.

他在和医生交谈时多次完全睡着了。

And he numerous times completely nodded off while he was talking to the doctor.

他说，每次这个人睡着时，冯·埃孔莫都能叫醒他，但永远无法让他完全清醒。

And he said every time the man fell asleep, Von Economo could rouse him, but never to full consciousness.

他说，这更像是从深睡中被叫醒的人，只是模糊地意识到自己不再睡觉。

He said he was more like someone who had been woken from a deep sleep and is only vaguely aware that they're no longer sleeping.

哦，这真奇怪。

Oh, that's weird.

到那时，冯·埃孔莫已经见过少数几名来自战争前线的患者出现这种类型的疲惫。

And by that point, Von Economo had seen this type exhaustion in, you know, a small number of patients who, again, had come from the front lines of war.

嗯。

Mhmm.

但这个人是个平民。

But this person was a civilian.

哦。

Oh.

所以现在情况开始扩散了。

So now he's like Now we're spreading.

因此，冯·埃孔莫和克鲁切亚记录的早期病例让他们都感到困惑。

So the early cases documented by Von Economo and Cruchea were baffling both of them.

这种疾病似乎与当时广泛流行的流感有相似之处。

This illness was seemed to have like similarities to influenza, which was very rampant at the time.

但它缺乏流感的许多典型特征。

But it lacked a lot of the defining characteristics of flu.

更奇怪的是，在少数出现嗜睡性脑炎的患者中，症状的种类也极其多样。

And more strange was the fact that among the small number of people who did present with encephalitis lethargica, there was again just the widest variety of symptoms.

冯·埃孔莫能做出的最佳判断是，他们似乎正在遭受脑炎，也就是脑组织肿胀。

The best von Economo could tell was that they appeared to be suffering from encephalitis, which is swelling of the brain tissue.

嗯。

Mhmm.

但这种肿胀没有解释。

But there was no explanation for that swelling.

比如，没有头部外伤的证据，也没有其他能真正解释它的损伤。

Like, was no evidence of head trauma, no other injury that could really account for it.

而且，虽然一些症状与典型的脑炎相符，比如发烧、头痛、意识模糊，但还有一些症状与脑炎完全无关。

And also, while some of the symptoms matched a typical case of encephalitis, which is like fever, headaches, confusion, there were others that were not associated with encephalitis at all.

真奇怪。

Weird.

是啊。

Yeah.

随着时间推移，冯·埃孔莫开始注意到病人出现新的症状，包括一场导致一人死亡的打嗝疫情。

So as the weeks go by, Von Economos started noticing new symptoms in his patients, including one epidemic of hiccuping that resulted in one death.

等等。

Wait.

他们确实。

They Yes.

打嗝声传遍了整个打嗝疫情，导致一人死亡。

Hiccuped heard themselves themselves to to An epidemic of hiccuping where one person died.

什么？

What the fuck?

是的。

Yeah.

他们死于打嗝。

Of they died of hiccuping.

是的。

Yeah.

这听起来像是最糟糕的、难以想象的死法。

Which sounds like the worst It's kind of death imaginable.

是的。

Yeah.

想想当你开始打嗝时有多糟糕。

Think of how awful it is when you start getting the hiccups.

然后你想着，就一个嗝。

And you're like, you've got one hiccup.

然后你心想：操。

And you're like, fuck.

快让它停下。

Get it gone.

我就想，给我点蜂蜜。

Like, I'm like, give me honey.

有人吓我一下。

Someone scare me.

我快憋不住了。

I'm Holy holding my shit.

这太糟了。

Like, that's awful.

是的。

Yeah.

知道。

Know.

这最糟糕了。

It's it's the worst.

此外，其他患者开始表现出更奇怪的症状，比如强迫性语言抽动、不受控制的眨眼、肌肉不自主抽搐、不受控制的流口水，还有少数人直接僵在原地，进入木僵状态。

Well, and then other patients started exhibiting even stranger symptoms like compulsive verbal tics, uncontrollable blinking, involuntary muscle twitching, uncontrolled salivation, and a small number of people who quote froze still in a catatonic state.

就像这种疾病在发展过程中不断出现新症状一样，是的。

It was like the disease was developing new symptoms as it progressed Yeah.

但完全找不到任何解释。

But with no explanation whatsoever.

尽管这些患者有许多共同症状，但所有患者唯一共有的症状是嗜睡。

And while these patients had a lot of symptoms in common, the only symptoms shared by all of them was hypersomnia.

好的。

Okay.

所以除此之外，他们都患有嗜睡症。

So other than that, it was like they all had hypersomnia.

其余的则是各种各样的异常表现。

The rest With of whole skew of different

但他们后来出现了

But then they had

大量完全超出现有认知范围的症状——冯·埃孔莫和克吕彻当时尚未交流，因为他们身处两地，但他们各自都发现了嗜睡性脑炎在临床表现上的模式。

a ton of shit that was just outside of Now in time, Von Economo and Crucher, who still had not compared notes at this point because they're in two different places, they recognized a pattern in the clinical presentation of encephalitis lethargica.

与更常见的脑炎形式不同，这种疾病分为急性期和慢性期两个阶段。

Like the more common form of, you know, encephalitis, the disease affected patients in two phases.

它分为急性期和慢性期。

It was acute and a chronic phase.

急性期的症状非常显著，比如过度嗜睡、眼球震颤、运动障碍，这些常见症状常伴随一些不太常见的症状。

The acute phase, you know, that had dramatic symptoms like excessive sleep, eye twitching, movement disorders, those common symptoms that were often accompanied by less common symptoms.

而这些不太常见的症状几乎像是每天都会出现又消失。

And these less common symptoms almost felt like they, like, came and went day to day.

就像它们某天突然出现，第二天又消失了。

Like, they kind of appeared one day and went the other.

是的。

And yeah.

显而易见，这种疾病的慢性阶段更难识别，可能在数月甚至数年后才显现。

For obvious reasons, the chronic phase of the disease took a lot longer to identify and could present months or even years later.

有时它们会以类似帕金森病的症状表现出来。

And they would sometimes present in the form of Parkinsonian like signs.

哦。

Oh.

嗯。

Yeah.

因此，在各自的诊所里，两位医生都埋头钻研医学文献，试图找到任何能帮助他们理解病情的线索，因为他们自己也在为治疗这些患者而犯难。

So at their respective clinics, both doctors are just like diving and pouring into medical literature, just trying to find anything that could figure out, because they're also having trouble treating these people too.

对。

Right.

只是想找一些与他们在前线归来的士兵身上看到的症状相似的病例，后来又在平民身上发现。

Just finding anything that resembled what they were seeing in, you know, first in soldiers returning from the front lines and then in civilians.

但冯·埃孔莫回忆起，他曾听说过十九世纪末意大利部分地区曾爆发过类似的瘟疫。

But Von Economo recalled hearing stories of a similar plague that had affected parts of Italy in the late nineteenth century.

根据这些故事，意大利一个乡村村庄的农民开始陷入类似昏迷的嗜睡状态，许多人再也没有醒来。

According to the stories, apparently peasants in a small village in rural Italy started falling into coma like sleep, and a lot of them never woke up.

那些醒过来的人，也不再是以前的自己了。

And those who did wake up were not the same as they were from before.

哦。

Oh.

这些人把这种病叫做‘La Nona’，也就是‘祖母’。

These these people called the disease La Nona, the grandmother.

La Nona。

La Nona.

La Nona。

La Nona.

但我认为我永远无法接受一种疾病被称为‘祖母’。

But I don't think I'll ever be over a disease being called The Grandmother.

这听起来像一部恐怖电影。

That sounds like a horror movie.

祖母。

The grandmother.

奶奶。

The grandma.

但在周围的城镇和村庄里，有症状的人被称为活死人。

But in the surrounding towns and villages, those who had symptoms were referred to as the living dead.

哦。

Oh.

是啊。

Yeah.

好吓人。

Spooky.

根据克罗斯比的说法，这是医生们首次考虑这种奇怪的嗜睡症是否与当时正在发生的流感疫情有关。

According to Crosby, this was the first time that doctors had considered whether the strange sleeping sickness could be related to the outbreak of influenza that was occurring at the time.

好的。

Okay.

基于这些理论，冯·伊科诺莫开始发展自己的理论，认为他在嗜睡性脑炎患者身上看到的这些异常症状可能是对流感暴露的反应。

Now based on those theories, Von Economos started developing his own theory that these strange symptoms he was seeing in his encephalitis lethargica patients could maybe be a reaction to exposure to influenza.

对。

Right.

1917年4月，他整理了所有笔记和观察结果，发表了一篇题为《嗜睡性脑炎》的论文。

In April 1917, he gathered all his notes and observation and published a manuscript appropriately titled Encephalitis lethargica.

巧合的是，就在这个时候——这完全是巧合。

Coincidentally, just a and this is total coincidence.

几天后，勒内·克鲁谢特也发表了他关于这一病例的论文，真奇怪。

Just a few days later, Rene Cruchet published his own paper on the case in That's weird.

是啊。

Yeah.

就像，两人都在研究这个病例。

Like, were both like on the case.

是的。

Yeah.

这两篇论文首次正式确认了这种疾病。

These two manuscripts were the first to formally identify the disease.

但在那之后的十年左右，关于这一主题的论文在各地发表了约9000篇，都在推测可能的病因，却没人能找出治疗方法、治愈手段，甚至无法确切确定病因。

But in the decade or so after that, roughly 9,000 papers on the subject would be published in various places, all theorizing what could be the cause, but absolutely no one being able to figure out the cure, the treatment, or really nailing down the cause.

好的。

Okay.

是的。

Yeah.

尽管这种疾病对患者的大脑和身体造成了可怕的伤害，但它最终却促成了关于大脑功能的一些重大发现。

Despite the horrific toll that this is taking on the patient's encephalitis lethargica is taking on a patient's brain and body, it would eventually lead to some pretty groundbreaking discoveries about the function of the brain in general.

那是，我记得，

That's As remember,

我们处于20世纪初。

we're in the early nineteen hundreds.

对。

Right.

所以，尽管他无法直接检查患者的脑部，至少在他们活着的时候不行。

So though he couldn't examine the brains of his patients directly, at least not while they're alive.

嗯。

Yeah.

冯·埃孔莫推测，患有嗜睡性脑炎的患者是被某种只影响大脑某一区域的病毒所感染。

Von Economo theorized that patients with encephalitis lethargica had been infected with some kind of virus that only affected one part of the brain.

好的。

Okay.

因此，他最终确定了受影响的区域——下丘脑，正是负责这一功能的部位，因为当时我们还不知道大脑各个部分的具体功能。

As a result, he would eventually establish that the affected region, the hypothalamus, was responsible because we didn't know what the parts of the brain were responsible for at this point.

但他能够逆向推断出，下丘脑负责调节睡眠、体温、口渴和饥饿等功能。

But he was able to, like, go backwards and figure out that the hypothalamus is responsible for, among other things, regulating sleep, body temperature, thirst and hunger and so on.

所以，就是这样。

So boom.

这真是突破性的。

That's groundbreaking.

是的。

Yeah.

这很重大。

That's big.

虽然现在这在神经学中至少被认为是基本知识。

While this is now considered pretty basic information in neurology at least.

是的。

Yeah.

但在当时，这是一个非常了不起的发现。

It was a really remarkable discovery in this day.

更重要的是，对于冯·埃孔莫和其他研究这种疾病的医生来说，这缩小了受影响区域的范围，帮助他们排除了其他疾病和神秘疾病的潜在病因。

And more importantly, at least for Von Economo and the other doctors studying this disease, it narrowed down the affected area and helped them to rule out other illnesses and potential causes of mystery illnesses.

但问题是，到了这十年末，嗜睡性脑炎不再仅仅影响从战场归来的士兵。

The problem though is that by the end of the decade, encephalitis lethargica was no longer just affecting soldiers returning from war.

更令人震惊的是，病例现在开始出现在巴黎和维也纳之外的地方。

But even more alarming was the fact that cases were popping up outside of Paris and Vienna now.

这种疾病传播的速度超出了他们的预期，而他们却无法阻止甚至减缓其蔓延，因为他们根本不知道这到底是什么东西。

The disease was spreading faster than they expected and they had no way of stopping it or even slowing it down because they didn't know what the fuck it was.

对。

Right.

所以你喜欢什么，你

So what do you like, what

会采取哪些预防措施？

precautions do you even put into place?

随着战争在欧洲、中东和北非持续蔓延，成千上万的士兵不断被调入和调出这些地区。

So as the war raged across Europe, The Middle East and Northern Africa, troops continued being moved in and out of those regions by the thousands.

当士兵受伤或阵亡时，他们会从战场上撤下，由健康的士兵接替，战争便继续进行。

As men men were injured or killed, they would be removed from battle and replaced with healthy soldiers and the war would continue.

在战争的背景下，这显然是必要的。

Now in the context of a battle, that's obviously a necessity.

但负责的人从未想到，通过在这些地区大量调动人员，他们为这种病毒的传播创造了完美的环境。

But it never occurred to anyone in charge that by moving so many people in and out of these places, they were creating the perfect environment for this virus to spread.

是的。

Yeah.

就在第一位患者在前线撤下后出现在冯·埃孔莫和克鲁沙伊诊所时，其他士兵也被轮换下战场，送往各自祖国的医院和诊所。

Now just as the first patient showed up at the Von Economo and Cruschay clinics after being taken off the front lines, other soldiers were cycled off the battlefield and sent to hospitals and clinics in their respective home countries.

当战争于1918年11月结束时，绝大多数幸存者都被送回家乡，同时把他们在服役期间感染的病菌带了回去。

When the war ended in November 1918, the vast majority who survived were shipped home, bringing with them the germs that they picked up while serving.

天哪。

Oh, man.

而且这很可能就像在船上

And it was probably just like popping off

在那些船上到处爆发一样。

all over those ships.

从1917年到1930年，近一百万人感染了嗜睡性脑炎。

Now between 1917 and 1930, nearly one million people contracted encephalitis lethargica.

天啊。

Damn.

在这些感染者中，大约有一半因症状而死亡。

And of those, roughly half died as a result of their symptoms.

天哪。

Jesus.

这些数字相对于其他大流行病和传染病来说并不算大。

Now those numbers are small relative to other pandemics and epidemics.

但对于一种如此奇特而神秘的疾病来说，嗜睡性脑炎疫情竟然从未引起广泛关注，简直就像医学史上的一个脚注，没错。

But for a remarkably bizarre and mysterious illness, it's pretty surprising that encephalitis lethargica, the epidemic, has never really had like a bit it's like a footnote Yeah.

在医学史上。

In medical history.

这太疯狂了。

Like, it's crazy.

嗯，同时，那时候诊断起来可能也很困难。

Well, at the same time, it was probably hard to diagnose too.

所以谁说得准呢，是啊。

So who's to Yeah.

到底有多少人死于这种病，谁又知道呢？

Who really knows how many people did die of that?

我们当时根本不知道。

We just didn't know.

没错。

Exactly.

造成这种状况的一个原因是，第一次世界大战结束后，全球传播的病原体中包括了西班牙流感。

Now, one reason for that status is the fact that among the germs passed around the world following the end of World War One was the Spanish flu.

是啊。

Yeah.

这种病毒肆虐了两年多，估计在全球造成了五千万人死亡。

A virus that raged for more than two years and killed an estimated fifty million people worldwide.

正如莫莉·考尔德韦尔·克罗斯比所说，在欧洲及其他地区，很少有人关注这种鲜为人知的嗜睡症疫情。

As Molly Caldwell Crosby Crosby said, in Europe and elsewhere, few people worried about the little known epidemic of sleep.

他们更关注在欧洲和美国军队中迅速蔓延、极具传染性的流感，这很合理。

They were preoccupied with the rapidly spreading, extremely virulent influenza breaking out among troops in Europe and The United States, which makes sense.

是的。

Yeah.

确实如此。

It does.

到1918年，嗜眠性脑炎已传至英国，在那里它像最初在法国和意大利出现时一样，令人困惑且难以界定。

Now by 1918, encephalitis lethargica had made its way to England, where it proved just as perplexing and unable to be defined as it had been when it first appeared in France and Italy.

最早报告的病例之一来自医生A.J.霍尔，当时他已经听说过这种疾病。

Among the first cases reported came from physician doctor AJ Hall, who by that time had already heard of this disease.

让霍尔感到异常的是，他的病人是一名小男孩，看起来并不特别疲惫或嗜睡，而是出现了肌肉无力，导致他无法将手臂或腿抬离床面。

And what struck Hall as unusual was that his patient, who was a young boy, did not seem really exhausted or even sleepy, but he was experiencing a level of muscle weakness that left him unable to lift an arm or leg off the bed.

该死。

Damn.

是的。

Yeah.

这太严重了。

That's intense.

所以他的身体很疲惫。

So his body was tired.

是的。

Yeah.

这与第一个前往冯·埃孔莫诊所的平民病例相似，那位患者无法在椅子上保持坐姿，也无法在任何时间段内抬起头来。

This was similar to the first civilian to visit Von Economo's clinic who was unable to hold himself up in the chair and keep his head up for any, like, period of time.

是的。

Yeah.

不久之后，其他脑炎嗜睡症病例开始出现在霍尔的诊所。

Now soon, other cases of encephalitis lethargica started showing up at Hall's clinic.

这些病例都伴随着当时肆虐的流感症状。

And they arrived with symptoms of the flu, which was rampant at the time.

但不久之后，症状就会加重。

But then a short time later, the symptoms would progress.

那时我们就会看到所有奇怪的嗜睡性脑炎症状。

And that's when we'd see all the strange encephalitis lethargica symptoms.

所有患者都表现出极度嗜睡和过度睡眠，这些症状似乎在白天对大多数患者影响更严重。

All suffered from profound lethargy and hypersomnia, which appeared to affect most patients more severely during the day.

有趣。

Interesting.

克罗斯比写道，仿佛他们的睡眠周期完全颠倒了。

Crosby wrote, it was as if their sleep cycle was turned around.

他们白天一直处于昏昏欲睡的麻木状态，到了晚上却变得谵妄。

They stayed in the sleepy stupor all day and became delirious at night.

到那时，英国患者中常见的一种或多种症状是倾向于喃喃自语或胡言乱语，就像在睡梦中说话一样。

And by that time, one or more common symptoms seen in patients in The UK was a tendency to mumble or ramble incoherently like they were talking in their sleep.

呃，这太吓人了。

Ew, that's so spooky.

这是最诡异的疾病。

It's the spookiest illness.

我不喜欢这样。

I don't like that.

随着感染人数的增长，更多令人不安的症状也开始出现。

As the numbers of infected were growing, more unnerving symptoms started coming out too.

患者会睁着眼睛睡着。

Patients would fall asleep with their eyes wide open.

不。

No.

闭嘴。

Shut the fuck up.

睁得大大的。

Wide open.

不。

No.

一动不动，呆滞地凝视着远方。

Unmoving, staring blankly into the distance.

不。

No.

其他人出现了面部肌张力增高，这是一种肌肉僵硬症，使他们的面部扭曲并固定成一种如面具般的恐怖表情。

Others got facial hypertonia, a type of muscle rigidity that left their faces twisted and fixed in a mask like expression of horror.

呃。

Ew.

嗯。

Yeah.

随着病例不断出现，患者身上还出现了其他一些极端但罕见的症状。

There were other extreme, though much less common symptoms seen in patients as more cases kept popping up.

在霍尔的诊所里，许多白天处于昏睡状态的患者，到了晚上会从这种状态中醒来，进入一种欣快状态，导致他们不停地说话或在床上翻滚。

And in Hall's clinic, many patients who would be in a stupor like state during the day would come out of that state in the evening and be in a state of euphoria, causing them to talk incessantly or writhe around in their beds.

什么鬼？

What the fuck?

什么？

What?

让你想到了南希在

Makes you think of Nancy at

手工艺结束时的样子。

the end of the craft.

是的。

Yes.

我立刻就想到了。

That's immediately what I thought of.

我送了你礼物。

I gave you the gift.

在其中一个病例中，一个男孩被描述为像伦敦街头出售的机械玩具‘跳跃甲虫’一样，四肢着地跃入空中。

And in one case, a young boy was described as, quote, leaping from all fours into the air like the mechanical toys sold on the London streets called jumping beetles.

什么？

What?

嗯。

Yeah.

他说，我感觉好点了。

He said, I feel better.

对。

Yep.

他晚上就会突然跳起来。

He would just jump at night.

这简直就是你感觉好了一毫秒时的样子，然后

That's literally you when you feel like a millisecond better and

医生们说，不，你还是病着。

the doctors are like, no, you still are sick.

往下。

Down.

振作起来。

Get it together.

确实如此。

It's true.

对一些人来说，极度的疲惫让他们对更明显的身体症状毫无察觉，因为他们太累了，根本无法感受到其他任何症状。

Now for some, the exhaustion rendered them unaware of their more physical symptoms because they were so tired they couldn't really experience any of the other symptoms.

嗯，就是状态不对劲。

Well, just like weren't with it.

是啊。

Yeah.

对另一些人来说，比如那个四肢着地跳起来的男孩，这些症状至少可以说是令人恐惧的。

For others, like the boy leaping from all fours, the symptoms were terrifying to say the very least.

是啊。

Yeah.

比症状表现更糟糕的是，遇到这种疾病的医生们根本无能为力。

Worse than the presentation of the symptoms was the fact that doctors who encountered the disease in their patients couldn't do really shit for them.

是啊。

Yeah.

因为他们根本不知道该治什么。

Well, because they just don't know what to treat.

嗯。

Yeah.

到1918年，这种疾病首次在英国出现时，病例已超过五百例。

By the 1918, the first year the disease appeared in England, there were more than five hundred cases.

在随后的几个月里，病例数量翻了一番。

And in the months that followed, the number doubled.

1919年1月，英格兰各地的城镇开始在报纸上发布通知，告知居民其所在区域已发现一例或多例病例，并敦促有症状者及时上报。

In January 1919, towns and cities across England started posting notices in the papers informing residents that one or more cases had been documented in their area and urging anyone with symptoms to report their case.

他们说：别乱跑，老铁。

They said lay low motherfuckers.

一则通知写道：鉴于该疾病性质严重，且诊断和治疗困难，每例病例都必须立即通知卫生官员。

One notice said, in view of the serious nature of the disease and the difficulties attending their treatment and presentation, it is highly important that notice be sent to the medical officer of health in every case without delay.

如今，在1919年初，当英国医生们刚刚开始应对这种神秘疾病时，美国也开始出现类似病例。

Now in the early months of 1919, as British physicians were just grappling with this mysterious illness, cases of this illness began appearing in The United States.

在纽约，多个病例以大规模集群形式出现，且集中在具有社交联系的群体中，这给了医生第一个线索：导致这种疾病的病因似乎通过密切接触传播。

In New York, several cases appeared in large clusters and among groups with social connections, giving doctors the first clue that whatever was causing this, it appeared to be spread through close contact.

是的。

Yeah.

为此，他们开始调查受影响个体之间的共同点，包括他们的居住条件、共享的食物和水源，以及出现症状者之间的亲属关系。

In response, they began investigating the commonalities among the affected individuals, including their living conditions, shared food, water sources, and any kinship relations between those showing symptoms.

在这一阶段记录的首批患者中，有一位名叫露丝的16岁女孩。

Now among the first patients documented in that phase was a 16 year old girl identified as Ruth.

那个冬天，她被送到曼哈顿的一家诊所。

That winter she was brought to the Manhattan clinic of Doctor.

弗雷德里克·蒂尔尼医生的诊所，他是这座城市最著名的神经学家之一。

Frederick Tilney, one of the city's most well known neurologists.

当蒂尔尼首次得知这位新患者时，他只知道她睡着了，再也醒不过来。

When Tilney was first informed of this new patient, all he was told was that she had fallen asleep and wouldn't wake up.

天啊。

Jesus.

到那时，蒂尔尼已经阅读了来自欧洲医生的医学文献，并认为自己已经见过几例轻度嗜睡症病例。

By that time, Tilney had already read the medical literature coming from the doctors in Europe and believed he had already seen a few mild cases of sleeping sickness.

因此，当露丝的父母描述她的症状时，他立刻说：她得了嗜眠性脑炎。

So when Ruth's parents described her symptoms, he was like, she got encephalitis lethargica.

他说她得了‘奶奶’。

He says she has the grandma.

‘奶奶’。

The grandma.

‘诺娜’。

The Nona.

‘诺娜’。

The Nona.

根据露丝父母的说法，她在圣诞节后一周的某个下午下班回家，开始抱怨——这是这个病例最奇怪的开端。

According to Ruth's parents, she had returned home from work one afternoon about a week after Christmas and began complaining and this is the strangest beginning to this.

她开始抱怨一根手指剧烈疼痛。

She started complaining of a sharp pain in one of her fingers.

随机的。

Random.

突然发生的。

That had come on suddenly.

什么？

What?

几小时内，疼痛就蔓延到她的手臂和肩膀，导致麻木，最终引发瘫痪。

Within hours, the pain had spread up her arm and into her shoulder causing numbness that would eventually lead to paralysis.

呃。

Ew.

第二天，露丝变得毫无理由地恐惧，并开始对父母暴力发作。

By the next day, Ruth had become irrationally fearful and started lashing out violently at her parents.

天哪。

Oh my god.

比如，她会咬牙切齿，疯狂地扭动。

Like, she would gnash her teeth and and like thrash wildly.

什么？

The fuck?

她才16岁。

She's 16.

是啊。

Yeah.

严重到她必须被镇静并束缚起来。

To the point that she had to be sedated and restrained.

他们说她就像一头野兽。

She was like a wild animal, they said.

谢天谢地。

Thank god.

不久后，她睡着了，怎么也叫不醒。

A short time later, she fell asleep and could not be roused.

等蒂尔尼医生被叫来时，她已经昏睡了两个月。

By the time doctor Tilney was called, she had been asleep for two months.

为什么拖了这么久才叫蒂尔尼医生？

Why did it take so long to call doctor Tilney?

因为我想她被转到另一家医院了。

Because I guess she was at a different hospital.

她当时插着胃管和静脉输液来维持营养。

She was she had a feeding tube and an IV drip to keep her nourished.

两个月？

Two months?

睡了两个月。

Two months sleeping.

该死。

Damn.

等等。

Wait.

回到那个手指的事上。

Back to that finger thing.

其实吧，这太疯狂了。

It's actually like, that's crazy.

我的新冠就是这样开始的，这是我唯一一次感染。

That's how I that's how my COVID started the first I've only had it once.

你的手指疼吗？

Your finger hurt?

不疼。

No.

但感觉差不多。

It's similar though.

我的肘部就像，那种关节痛。

My elbow was like and it's like joint pain.

但我的肘部疼得厉害。

But my elbow was so sore.

我记得我对德鲁说，天啊，我肘部现在疼得要命。

And I remember saying to Drew, I was like, oh my god, my elbow is so sore right

这太奇怪了。

That's so bizarre.

然后我全身开始疼痛，我想：我是不是感染了新冠？

And then the rest of my body started hurting and I was like, do I have COVID?

但它是从我的肘部开始的。

But it's it started in my elbow.

哇。

Wow.

这不是很奇怪吗？

Isn't that weird?

确实很奇怪。

That is weird.

我查了一下，确实有关节疼痛的症状。

When I looked it up, it was like, yeah, like joint pain.

就像这样，但当时只有一处，就是肘部特别僵硬。

Like it makes But it was one But it's just like, thick elbow.

疼。

Hurts.

嗯。

Yeah.

很奇怪。

Was weird.

露丝说，我的手指疼。

And Ruth was like, my finger hurts.

嗯。

Yeah.

我的意思是，手指更奇怪了。

I mean, the finger is like even stranger.

太疯狂了。

That's crazy.

嗯。

Yeah.

所以，在让蒂尔尼感到最困惑的事情中，有一件是：尽管她看起来在睡觉，但更奇怪的是，她还能回应简单的指令。

So among the things that puzzled Tilney the most was the fact that although she appeared to be asleep, this is even weirder, she was able to respond to simple commands.

嗯，这就像是当

Well, that's like when

我们最近在讨论昏迷的时候。

we were talking about, comas recently.

是的。

Yeah.

就像我们对

Like how we Like we don't have a lot of understanding about

他说，她就像处于催眠状态的人。

But she was like someone in a trance, he said.

她的眼睛和嘴巴都是闭着的。

Like her eyes and mouth were closed.

好的。

Okay.

但她能够回应医生的简单指令。

But she was able to respond to simple prompts from the doctor.

当蒂尔尼让露丝从床的一侧移动到另一侧时，她照做了。

When Tilney asked Ruth to shift her body from one side of the bed to the other, she did it.

所以她还能康复吗？

So she could still heal?

虽然很困难，但她确实做到了。

With difficulty, but she did

做到了。

it.

好的。

Okay.

到那时，她又出现了肌张力增高的症状，导致她手臂和腿部的肌肉变得僵硬，并保持在显然非常不舒服的姿势——我本来想说，这一定非常痛苦。

By that time, she had developed the additional symptom of hypertonia, which caused the muscles in her arms and legs to become rigid and stuck in what was surely uncomfortable positions for I was gonna say that must be so painful.

就卡在那里了。

It just stuck.

嗯。

Yeah.

根据克罗斯比的说法，当蒂尔尼试图把她从床上移开时，她开始颤抖。

According to Crosby, when Tilney tried to move her from the bed, she began to tremble.

颤抖从一只手或手臂开始，然后蔓延开来，直到她的整个身体都像兔子一样抽搐。

It started with a hand or arm and then spread until her entire body was convulsing in a rabbit like twitch.

我的天啊。

My god.

和世界上许多其他医生一样，蒂尔尼已经认识到嗜睡性脑炎的症状。

Like so many other doctors around the world, Tilney had come to recognize the symptoms of encephalitis lethargica.

嗯。

Yeah.

诺娜。

The Nona.

奶奶。

The grandma.

但他不知道该如何治疗。

But was at a loss for how to treat it.

这最糟糕的部分。

That's the worst part of it.

不，你懂的。

No, you do.

最终，他的建议基本上只是让露丝身体更舒适的方法。

In the end, his recommendations were just basically ways to make Ruth more physically comfortable.

嗯。

Yeah.

这说得通。

That makes sense.

但他不得不告诉她的父母，截至当时，没有治疗方法或治愈手段，他们的女儿很可能将长期处于这种状态。

But he was forced to tell her parents that as of that time, there was no treatment or cure, and that their doctor was their daughter was likely to stay in that state.

永远？

Forever?

事实上，几天后，露丝的体温飙升至107度，随后去世了。

In fact, a few days later, Ruth's temperature spiked to a 107 degrees and she died.

天哪。

Oh my god.

是的。

Yeah.

太可怕了。

That's awful.

在那样状态下生活了好几个月，真是惨不忍睹。

What a horrific After months of living that way.

是的。

Yeah.

太悲伤了。

That's so sad.

因此，随着病例在美国开始传播，人们对这种疾病的焦虑和恐惧也随之蔓延。

So as cases began spreading in The US, so did anxiety and fear now about this disease.

西班牙流感疫情影响了美国及全球数百万人，造成了大量死亡。

The Spanish flu epidemic had affected millions of people around The US and the world, killing massive numbers of people.

但流感是人们至少能够理解的疾病。

But influenza was something people could at least understand.

嗯。

Mhmm.

他们能够识别流感。

Like they could they could recognize influenza.

你知道流感是什么，对吧？

You know what a flu is, you know?

而且流感最致命的影响主要针对特定人群，这让普通公众觉得没那么可怕。

And also the most devastating effects of the flu affected certain populations, which made it less intimidating to the general public.

对。

Right.

而嗜睡性脑炎则完全不同，简直令人恐惧至极。

Encephalitis lethargica on the other hand was something fucking terrifying.

嗯。

Yeah.

好像任何人都可能感染。

It seems like anybody can get it.

完全奇怪、诡异、可怕又恐怖。

Totally weird and bizarre and scary and horrific.

嗯。

Yeah.

不仅患者的症状各不相同，而且这些症状在心理上令人不安、身体上致残，且似乎无法治疗。

Not only were the symptoms varied across patients, but they were psychologically disturbing, physically disabling, and seemingly impossible to treat.

即使有人侥幸熬过了急性期，慢性期也会带来类似帕金森的症状，那时生活将发生深远的改变。

And even if one did manage to survive the acute phase of illness, the chronic phase brought with it Parkinson's like symptoms that would be profoundly life altering at that point.

嗯。

Yeah.

这太吓人了。

Which is so scary.

人们一直与这种疾病共存。

People lived with this forever.

哇。

Wow.

尽管新病例现在在美国各地频繁出现，但美国公众仍寄望于医生和医护人员，解释这种似乎凭空出现的可怕疾病。

While new cases started popping up around The US with a lot of frequency now, the American public looked to doctors and health care workers to explain this scary disease that has seemed to come out of fucking nowhere.

是的。

Yeah.

但到那时，主流理论认为嗜睡性脑炎与最近肆虐的流感大流行有关。

But by that point, the predominant theory was that encephalitis lethargica was somehow related to the flu epidemic that had recently gone crazy.

就像一种变异的版本。

Like almost like a mutated Yeah.

就像从它身上突然衍生出来的。

Like almost just like a pop off of it.

你明白我的意思吗？

You know what I mean?

一个突然的爆发。

A pop off.

你知道的，一个快闪店。

You know, a quick pop up store.

突然爆发。

Popping off.

嗯。

Yeah.

就像是流感的一个快闪版本。

It's like a pop up version of the flu.

嗯。

Yeah.

因为很多症状，尤其是早期症状，都和流感病例相似，比如你会出现类似流感的症状。

Since so many of the symptoms, particularly the early ones, were seen in cases of the flu, like you would come in with flu like symptoms.

对。

Right.

脑炎是由感染引起的。

And encephalitis was caused by an infection.

人们有理由推测，嗜睡症是西班牙流感的后遗症。

It seemed reasonable to presume that the sleeping sickness was an after effect of the Spanish flu.

同样，就在几年前，疟疾疫情席卷了整个非洲大陆，其部分显著症状与病毒性脑炎患者的表现相似。

Similarly, just a few years earlier, an epidemic of malaria had spread across the African Continent, sharing several of the more prominent symptoms seen in patients with encephalitis lethargica.

因此，一些医生推测这种新出现的疾病可能与此有关。

As a result, some doctors theorized that the newly emerged disease could be related.

我的意思是，是的，我能理解他们为什么会这么想。

I mean, yeah, I could see why they would think that.

对。

Yeah.

到了早春，美国各地城市的管理者不得不应对日益增长的恐慌。

By early spring, administrators in cities across The US were forced to address this growing fear.

他们必须向公众做出说明。

They had to talk to the public.

他们不能就任由人们这样抱怨。

They couldn't just let them be like, ugh.

因为你会想，你能做什么呢？

Because it's like, what do you do?

比如，你要采取什么预防措施？

Like, what precautions do you take?

但最糟糕的是

But the worst part is

他们根本一无所知，他妈的

they have no Like, fucking

他们掌握的信息非常少。

they have like very little information.

有一集《海绵宝宝》里，他

There's this episode of SpongeBob where he

就是不想出门。

just like is not gonna go outside.

他唱了一首歌，歌词是待在室内。

And he sings this song where he's like, indoors.

室内。

Indoors.

这基本上就是他们所做的。

That's basically what they were doing.

那就是我。

That would be me.

他们只是挨家挨户。

They're just door to door.

待在屋里。

Stay inside.

在门里。

In the doors.

如今，在旧金山，市卫生部门于1919年3月初发布声明，称旧金山无需对睡眠病感到恐惧。

Now in San Francisco, the city's health department released a statement in early March nineteen nineteen saying San Francisco need have no fear of the sleeping sickness.

你别

Don't you

这样骗我。

lie to me like that.

作为流感的后遗症。

As an aftermath of the influenza.

众所周知，睡眠病由采采蝇传播，偶尔也由非洲和南方其他昆虫传播。

It is well established that the sleeping sickness is carried by the tsetse fly and occasionally by other insects found in Africa and the South.

它与流感毫无直接关联，流感的起源完全不同。

It has no direct connection with the influenza, which is an entirely different origin.

这话说得真蠢。

That's a bitch made statement.

这话说得非常荒谬，结果证明旧金山卫生官员在那份声明中的每一点都错了。

That's a very bitch made And it would turn out that San Francisco health officials were wrong on literally every point that they put in that.

还有，什么是采采蝇？

Also, what's a teetsey fly?

就像，就像一个小东西，我觉得几乎像蚊子那种

It's like it's like a little, I think it's almost like a mosquito kind

采采蝇。

of Teetsey fly.

仅仅四天后，这座城市里的医生就开始报告首例嗜睡性脑炎病例。

Just four days later, physicians in the city started reporting their first cases of encephalitis lethargica.

所以旧金山卫生部门的人说：不可能。

So they were to San Francisco Health and officials were like, it's nope.

别担心。

Don't worry.

这里不会。

Not here.

这里没有采采蝇。

No tsetse flies here.

滚开。

Get out of here.

不。

Nope.

然后四天后，他们说：‘抱歉，是我错了。’

And then four days later, they were like, so my bad.

这听起来有人觉得熟悉吗？

Does that sound familiar to anyone?

没有。

No.

这听起来完全陌生。

It sounds totally foreign.

这简直就像我们之前也被这样告知过。

It's can almost like we were told the same thing.

简直就是这样。

It's almost like that.

在其中一个病例中，一名当地铁路工人切斯特·琼斯出现了症状，并连续睡了十天。

In one case, a local railroad worker, Chester Jones, came down with symptoms and slept for ten days straight.

切斯特。

Chester.

就叫切斯特。

Just Chester.

说实话，如果这就是铁路工人生活的全部，他 probably 非常享受这十天的睡眠。

Honestly, he he probably, like, loved that ten days of sleep if that was it because of railroad workers.

那是一份辛苦的工作。

That's That's a hard job.

是的。

Yeah.

在那段时间里，琼斯的医生W。

During that period, Jones' doctor, W.

B。

B.

科菲，能够把他叫醒，让他吃下一点食物或喝点水。

Coffey, was able to rouse him long enough to eat a small amount of food or drink water.

但除此之外，他一直处于昏迷状态。

But otherwise, he was out.

该死。

Damn.

这可不是昏迷。

And and this isn't like a coma.

这才是关键。

That's the thing.

就像，是的。

It's like Yeah.

他们只是在睡觉。

They are sleeping.

是的。

Yeah.

就像直接睡着了，因为他们能叫醒他们，然后说：来，吃点东西。

Like straight because they can wake them up and be like, here have have a Right.

然后他们就说，好了，晚安。

Piece of And then they're like, alright, good night.

就像，继续睡吧。

Like, back to sleep.

这太疯狂了。

It's crazy.

他们会不会能起来上厕所之类的？

Are they like I wonder if they were like able to like get up to use the bathroom or Yeah.

或者类似的事情。

Or something like that.

现在咖啡说，我们在各种影响中遇到了打嗝和嗜睡症。

Now Coffee said we have had both hiccups and the sleeping sickness among the various other effects of the influence.

不是打嗝。

Not the hiccups.

所以打嗝又回来了。

So hiccups are back.

呃。

Ew.

这种嗜睡症要与由采采蝇传播、存在于热带地区的嗜睡症区分开来。

This form of sleeping sickness is to be distinguished from that which is carried by the tsetse fly and is found in the tropics.

所以他就像说：骗子。

So he's like, liars.

嗯。

Yeah.

你

You

不是同一种。

Not the same.

你们搞砸了。

You guys fucked up.

与此同时，在纽约，首例嗜睡症死亡病例被报告。

Meanwhile in New York, the first deaths from sleeping sickness were reported.