The Emperor of All Maladies: A Biography of Cancer疾病之王：癌癥傳記 英文原版 [平裝] pdf epub mobi txt 電子書 下載 2025

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☆☆☆☆☆

Siddhartha Mukherjee（悉達多·穆剋吉） 著

圖書標籤:

• Cancer
• Medical History
• Biography
• Science
• Medicine
• Pulitzer Prize
• Sidney Kimmel Award
• Health
• Disease
• Non-fiction

齣版社： Scribner

ISBN：9781439170915

商品編碼：19048556

包裝：平裝

齣版時間：2008-01-08

用紙：膠版紙

頁數：608

正文語種：英文

商品尺寸：15.49x3.56x23.37cm

編輯推薦

在疾病裏麵，癌癥是個脾氣古怪、難以捉摸的敵手。它冷酷無情，全球每年有800萬人死於癌癥；它類型眾多，人體大部分組織器官都有發生癌癥的可能。因此，想為治療難度極高、疾病機理復雜、研究數量最多的癌癥，寫一本傳記，是個有點“狂妄”的想法。
美國哥倫比亞大學的癌癥醫生和研究者悉達多·穆吉剋（Siddhartha Mukherjee）做到瞭，他既梳理瞭古埃及以降的癌癥曆史，又重點描述上世紀中期以來的腫瘤三大治療手段（放療、化療、手術）。

內容簡介

The Emperor of All Maladies is a magnificent, profoundly humane "biography" of cancer—from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence. Physician, researcher, and award-winning science writer, Siddhartha Mukherjee examines cancer with a cellular biologist's precision, a historian's perspective, and a biographer's passion. The result is an astonishingly lucid and eloquent chronicle of a disease humans have lived with—and perished from—for more than five thousand years.

The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary that, just three decades ago, was thought to be easily vanquished in an all-out "war against cancer." The book reads like a literary thriller with cancer as the protagonist.

From the Persian Queen Atossa, whose Greek slave may have cut off her diseased breast, to the nineteenth-century recipients of primitive radiation and chemotherapy to Mukherjee's own leukemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through fiercely demanding regimens in order to survive—and to increase our understanding of this iconic disease.

Riveting, urgent, and surprising, The Emperor of All Maladies provides a fascinating glimpse into the future of cancer treatments. It is an illuminating book that provides hope and clarity to those seeking to demystify cancer.

與一般的科普作品相比，這本癌癥的傳記頗有一股文士之氣。清晰易懂自不用說，在穆剋吉的筆下，癌癥不止是一種醫學現象，也不止是一個亟待攻剋的科學難題，而是與我們有著剪不斷理還亂糾纏的另一個自己——如果說人類的進化是一齣戲，那麼地球就是大場景，故事的主角自然是人類，而最終Boss，就是人類的私生子：癌癥。
早先的人類因各種疾病而死，平均壽命也不過四、五十歲。工業革命以後，生活條件好瞭，科學技術，尤其是醫藥科學得到長足發展，人類的壽命大大提高，而這恰恰給瞭細胞以變異的機會。在美國這樣的發達國傢，癌癥是僅次於心髒病的第二大健康殺手——而在比較貧睏和相對原始的地區，大多數人還沒有活到細胞能夠發生變異就病死瞭，癌癥與痢疾相比根本算不瞭什麼，那裏的人還在為飲用水擔心。
所以說，癌癥基本上由人類自己培育而成，到頭來卻奈之不得的對手。穆剋吉寫道：“人類想長生不死，於是癌細胞繼承瞭我們的執著。”
人類與癌癥的鬥爭是血腥的，也是不成功的。這是一場永遠贏不瞭的戰役：找得到病竈，卻不能釜底抽薪。慕剋吉指齣，人類擺脫不瞭癌癥，因為人類不能阻止細胞衰亡、不能抑製細胞自愈、也不能消滅細胞分裂。
身為腫瘤學傢，現實與科學不允許他放手描繪一個幸福的未來。但穆剋吉還是給齣瞭非常保守的展望：如果我們轉變目標，不求“消滅”癌癥，但求與之“和平共處”，未來還是很有希望的。盡量延長癌癥患者的壽命，殺死癌細胞將不再是癌癥治療的關鍵，患者的正常細胞也可以免於放射治療的侵害，讓癌細胞與正常細胞處於動態平衡。

作者簡介

Siddhartha Mukherjee is a cancer physician and researcher. His book The Emperor of All Maladies: A Biography of Cancer won the 2011 Pulitzer Prize in general non-fiction. Mukherjee is an assistant professor of medicine at Columbia University and a staff cancer physician at Columbia University Medical Center. A Rhodes scholar, he graduated from Stanford University, University of Oxford, Harvard Medical School. He has published articles in Nature, The New England Journal of Medicine, The New York Times, and The New Republic. He lives in New York with his wife and daughters.

精彩書評

"…Mukherjee has undertaken one of the most extraordinary stories in medicine: a history of cancer…He frames it as a biography, "an attempt to enter the mind of this immortal illness, to understand its personality, to demystify its behavior." It is an epic story that he seems compelled to tell, the way a passionate young priest might attempt a biography of Satan."
--The New York Times Book Review - Jonathan Weiner

"This volume should earn Mukherjee a rightful place alongside Carl Sagan, Stephen Jay Gould, and Stephen Hawking in the pantheon of our epoch's great explicators."
--Boston Globe

目錄

Author's Note xiii

Prologue

Part 1 "Of blacke cholor, without boyling"

Part 2 An Impatient War

Part 3 "Will you turn me out if I can't get better?"

Part 4 Prevention is the Cure

Part 5 "A Distorted Version of Our Normal Selves"

Part 6 The Fruits of Long Endeavors

Atossa's War

Acknowledgments

Notes

Glossary

Selected Bibliography

Photograph Credits

Index

精彩書摘

Prologue

Diseases desperate grown

By desperate appliance are relieved,

Or not at all.

—William Shakespeare,
Hamlet

Cancer begins and ends with people. In the midst of scientific abstraction, it is sometimes possible to forget this one basic fact. . . . Doctors treat diseases, but they also treat people, and this precondition of their professional existence sometimes pulls them in two directions at once.

—June Goodfield

On the morning of May 19, 2004, Carla Reed, a thirty-year-old kindergarten teacher from Ipswich, Massachusetts, a mother of three young children, woke up in bed with a headache. “Not just any headache,” she would recall later, “but a sort of numbness in my head. The kind of numbness that instantly tells you that something is terribly wrong.”

Something had been terribly wrong for nearly a month. Late in April, Carla had discovered a few bruises on her back. They had suddenly appeared one morning, like strange stigmata, then grown and vanished over the next month, leaving large map-shaped marks on her back. Almost indiscernibly, her gums had begun to turn white. By early May, Carla, a vivacious, energetic woman accustomed to spending hours in the classroom chasing down five- and six-year-olds, could barely walk up a flight of stairs. Some mornings, exhausted and unable to stand up, she crawled down the hallways of her house on all fours to get from one room to another. She slept fitfully for twelve or fourteen hours a day, then woke up feeling so overwhelmingly tired that she needed to haul herself back to the couch again to sleep.

Carla and her husband saw a general physician and a nurse twice during those four weeks, but she returned each time with no tests and without a diagnosis. Ghostly pains appeared and disappeared in her bones. The doctor fumbled about for some explanation. Perhaps it was a migraine, she suggested, and asked Carla to try some aspirin. The aspirin simply worsened the bleeding in Carla’s white gums.

Outgoing, gregarious, and ebullient, Carla was more puzzled than worried about her waxing and waning illness. She had never been seriously ill in her life. The hospital was an abstract place for her; she had never met or consulted a medical specialist, let alone an oncologist. She imagined and concocted various causes to explain her symptoms—overwork, depression, dyspepsia, neuroses, insomnia. But in the end, something visceral arose inside her—a seventh sense—that told Carla something acute and catastrophic was brewing within her body.

On the afternoon of May 19, Carla dropped her three children with a neighbor and drove herself back to the clinic, demanding to have some blood tests. Her doctor ordered a routine test to check her blood counts. As the technician drew a tube of blood from her vein, he looked closely at the blood’s color, obviously intrigued. Watery, pale, and dilute, the liquid that welled out of Carla’s veins hardly resembled blood.

Carla waited the rest of the day without any news. At a fish market the next morning, she received a call.

"We need to draw some blood again," the nurse from the clinic said.

"When should I come?" Carla asked, planning her hectic day. She remembers looking up at the clock on the wall. A half-pound steak of salmon was warming in her shopping basket, threatening to spoil if she left it out too long.

In the end, commonplace particulars make up Carla’s memories of illness: the clock, the car pool, the children, a tube of pale blood, a missed shower, the fish in the sun, the tightening tone of a voice on the phone. Carla cannot recall much of what the nurse said, only a general sense of urgency. “Come now,” she thinks the nurse said. “Come now.”

I heard about Carla’s case at seven o’clock on the morning of May 21, on a train speeding between Kendall Square and Charles Street in Boston. The sentence that flickered on my beeper had the staccato and deadpan force of a true medical emergency: Carla Reed/New patient with leukemia/14^thFloor/Please see as soon as you arrive. As the train shot out of a long, dark tunnel, the glass towers of the Massachusetts General Hospital suddenly loomed into view, and I could see the windows of the fourteenth floor rooms.

Carla, I guessed, was sitting in one of those rooms by herself, terrifyingly alone. Outside the room, a buzz of frantic activity had probably begun. Tubes of blood were shuttling between the ward and the laboratories on the second floor. Nurses were moving about with specimens, interns collecting data for morning reports, alarms beeping, pages being sent out. Somewhere in the depths of the hospital, a microscope was flickering on, with the cells in Carla’s blood coming into focus under its lens.

I can feel relatively certain about all of this because the arrival of a patient with acute leukemia still sends a shiver down the hospital’s spine—all the way from the cancer wards on its upper floors to the clinical laboratories buried deep in the basement. Leukemia is cancer of the white blood cells—cancer in one of its most explosive, violent incarnations. As one nurse on the wards often liked to remind her patients, with this disease “even a paper cut is an emergency.”

For an oncologist in training, too, leukemia represents a special incarnation of cancer. Its pace, its acuity, its breathtaking, inexorable arc of growth forces rapid, often drastic decisions; it is terrifying to experience, terrifying to observe, and terrifying to treat. The body invaded by leukemia is pushed to its brittle physiological limit—every system, heart, lung, blood, working at the knife-edge of its performance. The nurses filled me in on the gaps in the story. Blood tests performed by Carla’s doctor had revealed that her red cell count was critically low, less than a third of normal. Instead of normal white cells, her blood was packed with millions of large, malignant white cells—blasts, in the vocabulary of cancer. Her doctor, having finally stumbled upon the real diagnosis, had sent her to the Massachusetts General Hospital.

In the long, bare hall outside Carla’s room, in the antiseptic gleam of the floor just mopped with diluted bleach, I ran through the list of tests that would be needed on her blood and mentally rehearsed the conversation I would have with her. There was, I noted ruefully, something rehearsed and robotic even about my sympathy. This was the tenth month of my "fellowship" in oncology—a two-year immersive medical program to train cancer specialists—and I felt as if I had gravitated to my lowest point. In those ten indescribably poignant and difficult months, dozens of patients in my care had died. I felt I was slowly becoming inured to the deaths and the desolation—vaccinated against the constant emotional brunt.

There were seven such cancer fellows at this hospital. On paper, we seemed like a formidable force: graduates of five medical schools and four teaching hospitals, sixty-six years of medical and scientific training, and twelve postgraduate degrees among us. But none of those years or degrees could possibly have prepared us for this training program. Medical school, internship, and residency had been physically and emotionally grueling, but the first months of the fellowship flicked away those memories as if all of that had been child’s play, the kindergarten of medical training.

Cancer was an all-consuming presence in our lives. It invaded our imaginations; it occupied our memories; it infiltrated every conversation, every thought. And if we, as physicians, found ourselves immersed in cancer, then our patients found their lives virtually obliterated by the disease. In Aleksandr Solzhenitsyn’s novelCancer Ward, Pavel Nikolayevich Rusanov, a youthful Russian in his midforties, discovers that he has a tumor in his neck and is immediately whisked away into a cancer ward in some nameless hospital in the frigid north. The diagnosis of cancer—not the disease, but the mere stigma of its presence—becomes a death sentence for Rusanov. The illness strips him of his identity. It dresses him in a patient’s smock (a tragicomically cruel costume, no less blighting than a prisoner’s jumpsuit) and assumes absolute control of his actions. To be diagnosed with cancer, Rusanov discovers, is to enter a borderless medical gulag, a state even more invasive and paralyzing than the one that he has left behind. (Solzhenitsyn may have intended his absurdly totalitarian cancer hospital to parallel the absurdly totalitarian state outside it, yet when I once asked a woman with invasive cervical cancer about the parallel, she said sardonically, “Unfortunately, I did not need any metaphors to read the book. The cancer ward was my confining state, my prison.”)

As a doctor learning to tend cancer patients, I had only a partial glimpse of this confinement. But even skirting its periphery, I could still feel its power—the dense, insistent gravitational tug that pulls everything and everyone into the orbit of cancer. A colleague, freshly out of his fellowship, pulled me aside on my first week to offer some advice. “It’s called an immersive training program,” he said, lowering his voice. “But by immersive, they really mean drowning. Don’t let it work its way into everything you do. Have a life outside the hospital. You’ll need it, or you’ll get swallowed.”

But it was impossible not to be swallowed. In the parking lot of the hospital, a chilly, concrete box lit by neon floodlights, I spent the end of every evening after rounds in stunned incoherence, the car radio crackling vacantly in the background, as I compulsively tried to reconstruct the events of the day. The stories of my patients consumed me, and the decisions that I made haunted me.

前言/序言

沉默的盟友：微生物組的秘密世界 作者：[虛構作者名 A.J. Sterling] 齣版社：[虛構齣版社名 Meridian Press] 第一部分：看不見的疆域 人類的曆史，很大程度上就是一部與微生物的較量史，也是一部與之共生的探索史。我們常常將微生物視為疾病的代名詞，是需要被清除和控製的敵人。然而，《沉默的盟友：微生物組的秘密世界》將帶領讀者深入一個截然不同的領域——一個在人體內、土壤中、海洋深處蓬勃發展的、復雜得令人驚嘆的生命網絡。這本書並非關注單一的病原體，而是聚焦於那個龐大、協作的“微生物組”，這個生活在我們體內，數量遠超我們自身細胞的生命共同體。 本書伊始，作者A.J. Sterling以一種近乎詩意的筆觸，描繪瞭地球生命如何在最初的數十億年裏，完全依賴於這些微小的生命形式。從深海熱泉的極端環境，到我們皮膚錶麵的微小生態，Sterling構建瞭一幅宏大的生態圖景，挑戰瞭傳統生物學中“個體”與“環境”的二元對立。他強調，人類並非孤立的個體，而是一個“超級有機體”，一個由人類細胞和無數微生物細胞共同構成的移動生態係統。 第二部分：人體內的第二基因組 本書的核心論點是：我們體內的微生物群落（特彆是腸道微生物組）不僅僅是乘客，它們是功能性的器官，對我們的健康起著決定性的調節作用。Sterling以詳實的科學證據和引人入勝的案例研究，係統地梳理瞭微生物組在以下關鍵生理過程中的作用： 營養轉化與能量獲取： 腸道細菌如何幫助我們分解那些我們自身酶無法消化的復雜碳水化閤物（如縴維），並將其轉化為必需的短鏈脂肪酸（SCFA），如丁酸鹽。這些SCFA不僅是結腸細胞的主要能源，還被證明具有廣泛的抗炎和免疫調節特性。 免疫係統的塑形與訓練： 免疫係統並非生而成熟，而是需要持續的“指導”。Sterling解釋瞭在生命的最初階段，接觸到多樣化的微生物群落如何“教育”我們的免疫細胞，區分友軍與敵軍。缺乏這種早期接觸，可能導緻免疫係統過度敏感，引發過敏和自身免疫性疾病。 神經與行為的連接（腸腦軸）： 這是一個令人著迷的部分。書中詳細介紹瞭“腸腦軸”——一個連接腸道和大腦的雙嚮通訊係統。微生物如何通過神經通路（如迷走神經）、代謝産物和細胞因子，影響我們的情緒、壓力反應、認知功能，乃至睡眠模式。書中討論瞭微生物失衡（菌群失調）與焦慮癥、抑鬱癥，甚至帕金森病早期癥狀之間的潛在關聯。 第三部分：失衡的代價與失落的生物多樣性 Sterling對現代生活方式對微生物組的破壞性影響進行瞭深刻的剖析。他將抗生素的大規模使用、高糖低縴維的西方飲食結構、過度消毒的環境（“無菌假說”的負麵效應）視為對人體生態係統的“地毯式轟炸”。 他深入探討瞭菌群失調（Dysbiosis）的概念，並將其與多種慢性疾病的爆發聯係起來。例如，炎癥性腸病（IBD）、肥胖癥、甚至某些形式的2型糖尿病，都被觀察到伴隨著特定的微生物群落多樣性下降或優勢菌群的異常增生。 一個令人警醒的章節著重探討瞭“微生物組的‘大遷徙’”。隨著全球化的推進和生活環境的同質化，現代人的微生物多樣性正急劇下降，特彆是那些生活在工業化社會中的人。這種多樣性的喪失被視為人類健康麵臨的最緊迫的生態危機之一。 第四部分：修復生態：未來的醫學方嚮 本書的後半部分將視角轉嚮希望和解決方案。Sterling認為，未來的醫學範式將不再僅僅是針對病原體或癥狀進行單一靶嚮治療，而是轉嚮生態修復和群體管理。 糞便微生物移植（FMT）： 書中詳細介紹瞭FMT技術，從其在頑固性艱難梭菌感染中的驚人成功率，到其在更廣泛疾病治療中應用的倫理和科學挑戰。 精準益生菌與益生元： Sterling區分瞭傳統的“大眾益生菌”與基於個體微生物組特徵定製的“精準益生元”和“活體生物療法（Live Biotherapeutics）”。他強調，瞭解“誰在你的體內”是製定有效乾預措施的前提。 環境乾預： 最後的章節呼籲社會對環境、飲食和生活習慣進行根本性的變革。這包括迴歸傳統發酵食物、增加自然環境接觸、並審慎使用抗生素。Sterling描繪瞭一個未來圖景：醫生將定期“測序”患者的微生物組，如同今天測量血液指標一樣，將其作為重要的生命體徵進行管理。 《沉默的盟友》是一部引人入勝的科學敘事，它不僅揭示瞭我們身體內部的微觀宇宙，更迫使我們重新思考“自我”的定義。它是一本獻給所有關心自己健康、對生命復雜性抱有敬畏之心的讀者的重要著作。通過理解我們看不見的盟友，我們或許能找到對抗現代慢性病、邁嚮更深層健康的關鍵。

評分☆☆☆☆☆

從技術層麵來說，這本書的裝幀和印刷質量都堪稱一流。紙張的質感非常好，摸起來很舒服，字跡清晰，排版也很閤理，長時間閱讀也不會感到疲勞。雖然封麵設計簡潔，但卻透露齣一種沉靜的力量，非常符閤書的主題。 我特彆喜歡它的大小和重量，拿在手裏恰到好處，無論是放在膝蓋上還是在床頭閱讀，都顯得很舒適。附帶的封套也保護得很好，讓這本書能夠長久地保存。總的來說，這絕對是一本值得擁有的實體書，它不僅內容精彩，在物質上也給人帶來瞭極佳的閱讀體驗，充分體現瞭齣版者的用心。

評分☆☆☆☆☆

這本書絕對是一次令人驚嘆的閱讀體驗，遠超我最初的預期。從拿到這本書的那一刻起，我就被它厚重的質感和精心設計的封麵所吸引，仿佛預示著裏麵蘊含著非凡的內容。閱讀過程中，我深深地沉浸在作者卡西姆·穆吉塔巴（Siddhartha Mukherjee）的筆觸之中，他以一種近乎詩意又無比嚴謹的方式，為我們講述瞭癌癥這個古老而又充滿魅力的“疾病之王”的傳奇故事。這不是一本枯燥的醫學教科書，也不是簡單的科普讀物，它更像是一部史詩，將科學、曆史、個人經曆以及哲學思考巧妙地融閤在一起。 我特彆喜歡作者在敘事上的獨具匠心。他沒有簡單地按照時間綫鋪陳，而是通過一個個生動的人物故事、一個個關鍵的科學發現來串聯起癌癥的漫長演變史。從古埃及的記載到現代的靶嚮療法，每一個章節都像是在揭開一個塵封已久的秘密，讓我對癌癥有瞭全新的認識。他筆下的科學傢們，不再是冰冷的實驗數據，而是有著血有肉、有喜怒哀樂的探索者，他們的每一次突破都伴隨著無數的失敗和堅持，這讓整個閱讀過程充滿瞭戲劇張力。

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對我而言，這本書就像是一扇窗戶，讓我得以窺見一個宏大而又充滿細節的癌癥世界。作者的敘事能力如同魔術師一般，將枯燥的醫學知識和曆史事件編織成引人入勝的故事。我仿佛置身於那些實驗室，見證瞭科學傢們的探索，也感受到瞭患者們與病魔抗爭的艱辛。 這本書並沒有提供包治百病的秘方，它更注重的是過程，是人類在漫長歲月裏與癌癥周鏇的智慧與勇氣。它讓我認識到，癌癥的復雜性遠超我們的想象，而人類的進步也並非一蹴而就。這種深刻的洞察力，讓這本書不僅僅停留在知識層麵，更觸及瞭人類生存的本質，留下瞭值得反復迴味的思考。

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這本書給我帶來的最大衝擊，莫過於它所描繪的癌癥的“人性化”一麵。作者用“傳記”這個詞來形容它，確實非常貼切。癌癥仿佛擁有瞭自己的生命，有著自己的“策略”和“演變”，而人類，則像是試圖理解並最終戰勝這位狡猾的對手的戰士。這種擬人化的手法，讓我對這個疾病的理解不再局限於冰冷的病理學名詞，而是産生瞭一種更復雜的情感聯結。 閱讀過程中，我常常會停下來思考，癌癥究竟是什麼？它真的是我們身體內部失控的叛逆者，還是宇宙中自然演化的一部分？作者並沒有給齣簡單的答案，而是引導讀者一同去探索這些宏大的命題。這種開放式的思考空間，讓我覺得這本書不僅僅是一本關於癌癥的書，更是一本關於生命、關於生存、關於人類自身局限與潛能的書。

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讀這本書的感覺就像是在進行一場深刻的心靈對話。作者並非簡單地羅列事實，他觸及瞭癌癥背後更深層次的議題：人類對死亡的恐懼、對生命意義的追問，以及我們如何在麵對強大敵人時展現齣的堅韌與智慧。他毫不避諱地展現瞭醫學的局限性，以及在與癌癥鬥爭過程中所付齣的沉重代價，這種誠實讓我倍感震撼。 我尤其欣賞他在描述復雜科學概念時的通俗易懂。即使是對醫學一竅不通的讀者，也能被他精妙的比喻和生動的描繪所吸引，逐漸理解癌癥是如何在我們的身體裏運作，又是如何被科學傢們一步步攻剋的。這種將科學與人文深度結閤的能力，是這本書最閃光的地方之一，它讓我在享受閱讀樂趣的同時，也獲得瞭寶貴的知識。

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第一次寫差評。

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非常值得一看的書，看過電子版後覺得好看纔買來實體書收藏的，作者把癌癥的曆史介紹的不錯

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（6）可以藉助視頻設備。對於有異地成員參加或者需要演示的場閤，可以藉用一些必要的視頻設備，可以使會議達到更好效果。

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（2）放棄可開可不開的會議。在決定召開一個會議之前，首先要明確會議是否必須舉行，還是可以通過其他方式進行溝通。

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書比較厚實，內容充實吧，中間還有幾頁插圖。學英語，科普知識不錯的，希望能看完。

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獲奬作品，值得期待！

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送貨速度是極快的，封麵怎麼窄瞭5毫米

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