The Emperor of All Maladies: A Biography of Cancer疾病之王：癌症传记 英文原版 [平装] pdf epub mobi txt 电子书 下载 2025

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☆☆☆☆☆

Siddhartha Mukherjee（悉达多·穆克吉） 著

图书标签:

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

出版社： Scribner

ISBN：9781439170915

商品编码：19048556

包装：平装

出版时间：2008-01-08

用纸：胶版纸

页数：608

正文语种：英文

商品尺寸：15.49x3.56x23.37cm

编辑推荐

在疾病里面，癌症是个脾气古怪、难以捉摸的敌手。它冷酷无情，全球每年有800万人死于癌症；它类型众多，人体大部分组织器官都有发生癌症的可能。因此，想为治疗难度极高、疾病机理复杂、研究数量最多的癌症，写一本传记，是个有点“狂妄”的想法。
美国哥伦比亚大学的癌症医生和研究者悉达多·穆吉克（Siddhartha Mukherjee）做到了，他既梳理了古埃及以降的癌症历史，又重点描述上世纪中期以来的肿瘤三大治疗手段（放疗、化疗、手术）。

内容简介

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.

与一般的科普作品相比，这本癌症的传记颇有一股文士之气。清晰易懂自不用说，在穆克吉的笔下，癌症不止是一种医学现象，也不止是一个亟待攻克的科学难题，而是与我们有着剪不断理还乱纠缠的另一个自己——如果说人类的进化是一出戏，那么地球就是大场景，故事的主角自然是人类，而最终Boss，就是人类的私生子：癌症。
早先的人类因各种疾病而死，平均寿命也不过四、五十岁。工业革命以后，生活条件好了，科学技术，尤其是医药科学得到长足发展，人类的寿命大大提高，而这恰恰给了细胞以变异的机会。在美国这样的发达国家，癌症是仅次于心脏病的第二大健康杀手——而在比较贫困和相对原始的地区，大多数人还没有活到细胞能够发生变异就病死了，癌症与痢疾相比根本算不了什么，那里的人还在为饮用水担心。
所以说，癌症基本上由人类自己培育而成，到头来却奈之不得的对手。穆克吉写道：“人类想长生不死，于是癌细胞继承了我们的执着。”
人类与癌症的斗争是血腥的，也是不成功的。这是一场永远赢不了的战役：找得到病灶，却不能釜底抽薪。慕克吉指出，人类摆脱不了癌症，因为人类不能阻止细胞衰亡、不能抑制细胞自愈、也不能消灭细胞分裂。
身为肿瘤学家，现实与科学不允许他放手描绘一个幸福的未来。但穆克吉还是给出了非常保守的展望：如果我们转变目标，不求“消灭”癌症，但求与之“和平共处”，未来还是很有希望的。尽量延长癌症患者的寿命，杀死癌细胞将不再是癌症治疗的关键，患者的正常细胞也可以免于放射治疗的侵害，让癌细胞与正常细胞处于动态平衡。

作者简介

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.

精彩书评

"…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

目录

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

精彩书摘

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：微生物组的秘密世界 作者：[虚构作者名 A.J. Sterling] 出版社：[虚构出版社名 Meridian Press] 第一部分：看不见的疆域 人类的历史，很大程度上就是一部与微生物的较量史，也是一部与之共生的探索史。我们常常将微生物视为疾病的代名词，是需要被清除和控制的敌人。然而，《沉默的盟友：微生物组的秘密世界》将带领读者深入一个截然不同的领域——一个在人体内、土壤中、海洋深处蓬勃发展的、复杂得令人惊叹的生命网络。这本书并非关注单一的病原体，而是聚焦于那个庞大、协作的“微生物组”，这个生活在我们体内，数量远超我们自身细胞的生命共同体。 本书伊始，作者A.J. Sterling以一种近乎诗意的笔触，描绘了地球生命如何在最初的数十亿年里，完全依赖于这些微小的生命形式。从深海热泉的极端环境，到我们皮肤表面的微小生态，Sterling构建了一幅宏大的生态图景，挑战了传统生物学中“个体”与“环境”的二元对立。他强调，人类并非孤立的个体，而是一个“超级有机体”，一个由人类细胞和无数微生物细胞共同构成的移动生态系统。 第二部分：人体内的第二基因组 本书的核心论点是：我们体内的微生物群落（特别是肠道微生物组）不仅仅是乘客，它们是功能性的器官，对我们的健康起着决定性的调节作用。Sterling以详实的科学证据和引人入胜的案例研究，系统地梳理了微生物组在以下关键生理过程中的作用： 营养转化与能量获取： 肠道细菌如何帮助我们分解那些我们自身酶无法消化的复杂碳水化合物（如纤维），并将其转化为必需的短链脂肪酸（SCFA），如丁酸盐。这些SCFA不仅是结肠细胞的主要能源，还被证明具有广泛的抗炎和免疫调节特性。 免疫系统的塑形与训练： 免疫系统并非生而成熟，而是需要持续的“指导”。Sterling解释了在生命的最初阶段，接触到多样化的微生物群落如何“教育”我们的免疫细胞，区分友军与敌军。缺乏这种早期接触，可能导致免疫系统过度敏感，引发过敏和自身免疫性疾病。 神经与行为的连接（肠脑轴）： 这是一个令人着迷的部分。书中详细介绍了“肠脑轴”——一个连接肠道和大脑的双向通讯系统。微生物如何通过神经通路（如迷走神经）、代谢产物和细胞因子，影响我们的情绪、压力反应、认知功能，乃至睡眠模式。书中讨论了微生物失衡（菌群失调）与焦虑症、抑郁症，甚至帕金森病早期症状之间的潜在关联。 第三部分：失衡的代价与失落的生物多样性 Sterling对现代生活方式对微生物组的破坏性影响进行了深刻的剖析。他将抗生素的大规模使用、高糖低纤维的西方饮食结构、过度消毒的环境（“无菌假说”的负面效应）视为对人体生态系统的“地毯式轰炸”。 他深入探讨了菌群失调（Dysbiosis）的概念，并将其与多种慢性疾病的爆发联系起来。例如，炎症性肠病（IBD）、肥胖症、甚至某些形式的2型糖尿病，都被观察到伴随着特定的微生物群落多样性下降或优势菌群的异常增生。 一个令人警醒的章节着重探讨了“微生物组的‘大迁徙’”。随着全球化的推进和生活环境的同质化，现代人的微生物多样性正急剧下降，特别是那些生活在工业化社会中的人。这种多样性的丧失被视为人类健康面临的最紧迫的生态危机之一。 第四部分：修复生态：未来的医学方向 本书的后半部分将视角转向希望和解决方案。Sterling认为，未来的医学范式将不再仅仅是针对病原体或症状进行单一靶向治疗，而是转向生态修复和群体管理。 粪便微生物移植（FMT）： 书中详细介绍了FMT技术，从其在顽固性艰难梭菌感染中的惊人成功率，到其在更广泛疾病治疗中应用的伦理和科学挑战。 精准益生菌与益生元： Sterling区分了传统的“大众益生菌”与基于个体微生物组特征定制的“精准益生元”和“活体生物疗法（Live Biotherapeutics）”。他强调，了解“谁在你的体内”是制定有效干预措施的前提。 环境干预： 最后的章节呼吁社会对环境、饮食和生活习惯进行根本性的变革。这包括回归传统发酵食物、增加自然环境接触、并审慎使用抗生素。Sterling描绘了一个未来图景：医生将定期“测序”患者的微生物组，如同今天测量血液指标一样，将其作为重要的生命体征进行管理。 《沉默的盟友》是一部引人入胜的科学叙事，它不仅揭示了我们身体内部的微观宇宙，更迫使我们重新思考“自我”的定义。它是一本献给所有关心自己健康、对生命复杂性抱有敬畏之心的读者的重要著作。通过理解我们看不见的盟友，我们或许能找到对抗现代慢性病、迈向更深层健康的关键。

评分☆☆☆☆☆

读这本书的感觉就像是在进行一场深刻的心灵对话。作者并非简单地罗列事实，他触及了癌症背后更深层次的议题：人类对死亡的恐惧、对生命意义的追问，以及我们如何在面对强大敌人时展现出的坚韧与智慧。他毫不避讳地展现了医学的局限性，以及在与癌症斗争过程中所付出的沉重代价，这种诚实让我倍感震撼。 我尤其欣赏他在描述复杂科学概念时的通俗易懂。即使是对医学一窍不通的读者，也能被他精妙的比喻和生动的描绘所吸引，逐渐理解癌症是如何在我们的身体里运作，又是如何被科学家们一步步攻克的。这种将科学与人文深度结合的能力，是这本书最闪光的地方之一，它让我在享受阅读乐趣的同时，也获得了宝贵的知识。

评分☆☆☆☆☆

对我而言，这本书就像是一扇窗户，让我得以窥见一个宏大而又充满细节的癌症世界。作者的叙事能力如同魔术师一般，将枯燥的医学知识和历史事件编织成引人入胜的故事。我仿佛置身于那些实验室，见证了科学家们的探索，也感受到了患者们与病魔抗争的艰辛。 这本书并没有提供包治百病的秘方，它更注重的是过程，是人类在漫长岁月里与癌症周旋的智慧与勇气。它让我认识到，癌症的复杂性远超我们的想象，而人类的进步也并非一蹴而就。这种深刻的洞察力，让这本书不仅仅停留在知识层面，更触及了人类生存的本质，留下了值得反复回味的思考。

评分☆☆☆☆☆

这本书给我带来的最大冲击，莫过于它所描绘的癌症的“人性化”一面。作者用“传记”这个词来形容它，确实非常贴切。癌症仿佛拥有了自己的生命，有着自己的“策略”和“演变”，而人类，则像是试图理解并最终战胜这位狡猾的对手的战士。这种拟人化的手法，让我对这个疾病的理解不再局限于冰冷的病理学名词，而是产生了一种更复杂的情感联结。 阅读过程中，我常常会停下来思考，癌症究竟是什么？它真的是我们身体内部失控的叛逆者，还是宇宙中自然演化的一部分？作者并没有给出简单的答案，而是引导读者一同去探索这些宏大的命题。这种开放式的思考空间，让我觉得这本书不仅仅是一本关于癌症的书，更是一本关于生命、关于生存、关于人类自身局限与潜能的书。

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这本书绝对是一次令人惊叹的阅读体验，远超我最初的预期。从拿到这本书的那一刻起，我就被它厚重的质感和精心设计的封面所吸引，仿佛预示着里面蕴含着非凡的内容。阅读过程中，我深深地沉浸在作者卡西姆·穆吉塔巴（Siddhartha Mukherjee）的笔触之中，他以一种近乎诗意又无比严谨的方式，为我们讲述了癌症这个古老而又充满魅力的“疾病之王”的传奇故事。这不是一本枯燥的医学教科书，也不是简单的科普读物，它更像是一部史诗，将科学、历史、个人经历以及哲学思考巧妙地融合在一起。 我特别喜欢作者在叙事上的独具匠心。他没有简单地按照时间线铺陈，而是通过一个个生动的人物故事、一个个关键的科学发现来串联起癌症的漫长演变史。从古埃及的记载到现代的靶向疗法，每一个章节都像是在揭开一个尘封已久的秘密，让我对癌症有了全新的认识。他笔下的科学家们，不再是冰冷的实验数据，而是有着血有肉、有喜怒哀乐的探索者，他们的每一次突破都伴随着无数的失败和坚持，这让整个阅读过程充满了戏剧张力。

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从技术层面来说，这本书的装帧和印刷质量都堪称一流。纸张的质感非常好，摸起来很舒服，字迹清晰，排版也很合理，长时间阅读也不会感到疲劳。虽然封面设计简洁，但却透露出一种沉静的力量，非常符合书的主题。 我特别喜欢它的大小和重量，拿在手里恰到好处，无论是放在膝盖上还是在床头阅读，都显得很舒适。附带的封套也保护得很好，让这本书能够长久地保存。总的来说，这绝对是一本值得拥有的实体书，它不仅内容精彩，在物质上也给人带来了极佳的阅读体验，充分体现了出版者的用心。

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送货速度是极快的，封面怎么窄了5毫米

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（6）可以借助视频设备。对于有异地成员参加或者需要演示的场合，可以借用一些必要的视频设备，可以使会议达到更好效果。

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获奖作品，值得期待！

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获奖作品，值得期待！

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主持人根据会议议程的规定控制会议的节奏，保证每一个问题都得到讨论。

评分☆☆☆☆☆

（6）可以借助视频设备。对于有异地成员参加或者需要演示的场合，可以借用一些必要的视频设备，可以使会议达到更好效果。

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主持人根据会议议程的规定控制会议的节奏，保证每一个问题都得到讨论。

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开本很大，接近A4纸大小，价格18刀，还算厚道。。。

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没想到jd的外文原版书也这么给力，很快就到了