If everything — even dressing in the morning — throws you, if every little setback makes you throw a wobbly then you don't have style.

I screamed “Get them out of here" but they stayed and had a good view of what was going on. I was in a bit of a state. When they'd gone I threw a wobbly, kicking and screaming.

A less common variant is wobbler. When the Dutch bosses in Eindho­ven heard the ads they threw a wobbler and cancelled them

Wobbly, often, as here in the phrase “throw a wobbly”, seems to have emerged into the general language in the last four or five years, probably from a London subculture argot. It may derive from the violent shaking of someone who cannot control his or her anger.

Imaging

(from LRONW)

A therapeutic technique for relieving stress by summoning up mental pictures of pleasant things or activities.

For employees who want to learn how to decompress, experts recom­mend several forms of relief. Allen Elkin, program director for Strcsscare, suggests abdominal breathing, meditation, and imaging.

Exploding Head Syndrome

(from LRONW)

A sensation of explosive noise deep in the centre or back of the head, waking the sufferer from sleep.

A previously unrcported medical condition known as the Exploding Head Syndrome in which patients experience a bomb-like explosion in the back of the head, waking the sufferer from sleep, is described by a consultant neurologist in the weekly medical journal "The Lancet today"

People who suffer from this alarming condition tend to be middle-aged or elderly women, but it does not appear to be linked to any other form of ill health (not even, as its name might suggest, to having one too many the night before), and its cause is so far unexplained.

Cerebellar Syndrome

(from LRONW)

A set of symptoms (e. g. loss of muscle tone and muscular coordination, impaired speech, and involuntary spasmodic movement of the eyeball) indicating disease of the cerebellar hemisphere.

Glyn Worsnip rcccivcd more than 1000 letters from well-wishers after sharing his feelings on radio about contracting cercbcllar syndrome, a rare brain disease that affects both speech and movement.

Cerebellar syndrome is a well-documented medical condition, but had not really impinged on public awareness until 1987, when television presenter Glyn Worsnip revealed that he was suffering from it. It is alternatively called Nonne’s syndrome, after Max Nonnc, a 19th-century German neurologist.

Altered State off Consciousness

(from SBD)

Any state of mind that differs from the normal mental state of a conscious person.

Other cultures have long had techniques for arriving at altered states of consciousness — through such means as chanting, whirling, fasting, breathing exercises, and flagelation. Now such procedures are recognized to have dramatic effects on body chemicals which contribute to the achievement of the desired state.

It is beginning to be thought that telepathy, clairvoyance, mystical transports, and other altered states of consciousness may be latent in most, if not all, of us, along with psychic powers dominions not demonstrated.

Cytomegalovirus

(from SBD)

A virus which causes a disease of the central nervous system similar to infectious mononucleosis, attacking and enlarging cells, and is characterized by inclusion bodies in the cell nu­cleus.

Cytomegalovirus and herpes simplex virus have led to brain damage, deafness, blindness and other malformations of the central nervous system.

Mnemon

(from SBD)

Mnemon ['nirmsn] is a minimal unit of information stored in the brain or nervous system: a theoretical unit of memory encoded in a nerve-cell pathway.

If a mnemon in an octopus brain is thought of as a single word on a signpost - a simple "Stop" or “Go" — then the mnemos in a human brain must be equivalent to whole sentences, paragraphs, even books, containing elaborate "programs” for guiding our future thoughts, feelings and actions.

Saving Spina Bifida¹ Babies

(from "Newsweek”)

Suzy Mace is a cheerful, pretty four-and-a-half-year-old who enjoys riding her tricycle and singing the alphabet song. But when she was born, doctors informed her parents - incorrectly, as it turned out — that she was paralized, men­tally retarded and would almost certainly never walk. “They left us with the feeling she'd better off dead than alive”, recalls Joyce Mace. “We could have lost her to sheer igno­rance”.

Suzy is a victim of spina bifida (cleft spine), a potentially devastating birth defect that strikes one in every 1,000 new­borns. Until recently, most SB babies died shortly after birth or suffered severe physical and mental handicaps. Today, many physicians still don't realize that the outlook for children like Suzy Mace is considerably brighter nearly all afflicted babies survive, many with normal intelligence and the potential to lead independent and productive lives.

Unprotected nerves: SB (spina bifida) occurs when one or more of the spinal vertebrae fail to close completely. The spinal cord and nerves in that area, which normally control muscles and sensation in the bladder, bowels and legs, may bulge through the opening in the bone and form a fluid-filled sac protruding from the childs back. Because the sac, called a myelomeningocele² is often only partly covered by a fragile membrane, the unprotected nerves are easily damaged and the risk of paralysis and infection is high.

After surgery, SB children are seen regularly by a team that includes an orthopedist, urologist, physical therapist and psychologist. “This allows for quick action”, says McLone. “If we were all working independently, who knows how long it would take us to sort things out”. McLone’s team studied 100 newborns with SB. Fourteen of the children have died since 1975, many from severe brain malformations that simply couldn’t be treated successfully. The survivors are now bet­ween three and a half and seven years old. Thirty-seven of these youngsters, McLone reports, are essentially normal, al­though some must use walkers. Another group of the same size has moderate impairment, such as incontinence of con­finement to a wheelchair. And the remainder — about a dozen of children - suffer from severe physical or mental handicaps.

Clearly, the physical limitations imposed by SB vary wide­ly. “We can’t create what isn’t there,” says McLone. “We are at the mercy of what’s left after the disaster at the lower end of the spine”. While some SB children can walk unassisted, the majority must rely on braces and crutches. A new type of “spring” brace is particularly promising: it helps propel the child’s leg forward with each step he takes. Nonetheless, SB victims who are adolescents often decide they prefer the in­creased mobility of a wheelchair.

Prevention: SB is probably caused by a combination of heredity and environment. It is most common among northern Europeans, less so among Jews and blacks; it is also more prevalent in families who already have an affected child. Through a complicated series of tests, the abnormality can be detected prenatally, so parents can decide whether to continue the pregnancy.

Notes

'spina bifida (SB) f'spaina'baifida] — defective closure of the vertebral column through which the spinal cord or meninges may or may not protrude

²myelomeningocele [₍maiabume'ningDusela] — the condi­tion when the neural tissue protrudes to the surface with the meninges

Task 12. Read the comprehension questions and try to answer them. Choose the answers below:

Task 13. Read an additional text from “U.S. News and World Report". Make yourgroupmates know its content:

U.S. STUDY LINKS SCHIZOPHRENIA TO PHYSICAL DEFECTS

Tests show abnormalities in the blood flow in brains of mental pa­tients

The flow of blood to the crucial centers of reason in the brains of schizophrenics is partially blocked when they are asked to perform intellectual tasks, according to researchers at St. Elizabeth’s Hospital.

The observations strengthens the growing belief that schi­zophrenia may be a physical disease caused by abnormali­ties in the brain, rather than a purely mental or emotional problem.

The disturbed blood flow has been seen by National Insti­tutes of Mental Health scientists in eight young chronic schi­zophrenics — men in their 20s and 30s — in a research ward at St. Elizabeth’s.

Dr. Daniel Weinberg, head of the institutes’ research team, said that more extensive studies would be needed before the results could be called conclusive.

Four of the eight patients showed a sharp drop in blood flow to the brain’s frontal lobes when they tried to perform a simple card-matching test. All eight showed at least some diminished flow, and none was able to do the card test, one most normally reasoning people would master in minutes.

A new brain-imaging technique, Dr. Weinberger reported, has shown that in a simple test requiring use of the brain’s frontal lobes, these lobes seem to “turn off’’.

If the brain is viewed as a computer, he said, the findings suggest that the patients' frontal lobes “seem to have a com­puter crash. Their frontal lobes go off-line’’.

The human brain has two hemispheres, like the two halves of a walnut, each of which is divided into sections or lobes. The frontal lobes are in many ways the most advanced sec­tions, vital to normal awareness and judgement.

Schizophrenia is characterized by flattened emotions, de­ranged insight, inappropriate behavior and social withdrawal. According to Dr. Weinberger, several lines of evidence sug­gest that this common mental disease involves defects in both frontal lobes and the limbic system, a group of structures within the brain.

“There may be a host of defects in the limbic-frontal arran­gements" Dr. Weinberger said. The resulting frontal-lobe disor­der, he said, may help to explain the illness’s symptoms.

To test this idea, Dr. Weinberger and colleagues at the St. Elizabeth’s research unit asked their patients to breathe some mildly radioactive xenon gas for one minute.

The gas was carried to the brain via the blood. The patients were then asked to perform the card test — matching colored stars, triangles, crosses and dots on a TV-like screen — while 32 small detectors measured blood flow in the brain.

The faster the blood flow in any region, the faster the radioactivity dissappeared. In at least half the patients, the sluggish flow in the frontal lobes showed that the blood was not delivering enough glucose to fuel brain cells.

Such physical defects may be hereditary, Dr. Weinberger said, or caused by disease, perhaps “a viral infection that has obliterated some connections’’.

A physical cause for schizophrenia, some scientists say, does not rule out the part of emotional upset as the element triggering the disease in the physically vulnerable.

Task 14. Use these expressions in the sentences of your own to show that you understand the content of the article above:

1) to be asked to do smth.; 2) smth. is caused by smth.; 3) smth. would be needed before smth.; 4) to try to do smth.; 5) to be able to do smth.; 6) the findings suggest that...; 7) smth. is divided into smth.; 8) smth. is characteri­zed by smth.; 9) in both ... and ...; 10) to carry smth. via smth.

(a) more extensive studies ...; b) they tried to perform a simple card-matching test; c) each hemisphere is divided into sections or lobes; d) schizophrenia is characterized by inap­propriate behavior, social withdrawal; e) schizophrenics are asked to perform intellectual tasks ...; f) a physical disease caused by abnormalities in the brain...; g) in both the frontal lobes and within the brain; h) the gas was carried to the brain via blood; i) ... the patient’s frontal lobes seem to have a computer crash; j) none was able to do card-test)

Task IS. Try to memorize the meaning of some addi­tional clinical terms connected with the pathological con­ditions of the nervous system:

tumours of brain — growths of brain tissue and meninges of

abnormal character

syncope ['sigkapi] — a temporary deficiency of blood supply to the brain which causes loss of consciousness or fainting glioma [gli'ouma] — a tumour that arises from supporting structure of nerves — neuroglia. It grows on the brain, spinal cord, etc. glioblastoma [,glnu'blaestama] — occurs mainly in the ce­rebrum of adults meningioma ['meningioma] — a tumour from meninges astrocytoma [_<sstro(u)sai't3m3] — tumour on a star-shaped cell of the brain and spinal cord (most often occurs in childhood in cerebellum) medulloblastoma [.medjula'blaestama] - it is common in childhood and is derived from cerebellar embryonic cells Parkinson’s disease — a degenerative disease of later life, characterized by a rhythmic tremor and muscular rigidity caused by degeneration in the basal ganglia of the brain (Parkinson James — English physician who first descri­bed it)

myasthenia gravis [,maiaes'0i:ma'greivis] - a disease of faulty nerve conduction characterized by weakness and quick fa­tigue of muscles, especially of the face and neck, lips, tongue, throat

multiple sclerosis — a chronic disease in which there is scattered demyelination of the central nervous system: it is characterized by speech defects, loss of muscular coordina­tion, etc.

thrombosis — a clot coagulation in a blood vessel or in the heart. It is the most common type of stroke embolism — the obstruction of a blood vessel (including the one leading to the brain) by an embolus (a piece of clot which breaks off from its place of origin) and which is too large to pass through a blood vessel and causes a sudden stroke

hemorrhage — the escape of large quantities of blood vessel; heavy bleeding because of degeneration of cerebral arte­ries. They can burst on account of high blood pressure, arteriosclerosis. Usually hemorrhage demages the nerve cells in the motor region of the cerebrum and the patient is hemiplegic and aphasic coma — a state of deep and prolonged unconsciousness caused by injury or disease; a condition of stupor and lethargy hydrocephalus — a condition characterized by an abnormal increase and accumulation of fluid in the cranium, especially in young children, causing enlargement of the head and destruction of the brain

meningitis — inflammation of the meninges, especially, as a result of infection by bacteria or viruses of the subarachnoid space of the meninges epilepsy — a chronic disease of the nervous system, charac­terized by convultions and often, unconsciousness (gland mal — convultions and loss of consciousness; petit mal — attacks of momentary unconsciousness without convultions) apoplexy - sudden paralysis with total or partial loss of consciousness and sensation caused by the breaking or obstruction of a blood vessel in the brain

Task 16. Fill in the blanks with the appropriate words given below:

t. Myasthenia gravis can be ... by quick fatigue of muscles.

2. The vision can be... by an oculist (ophthalmologist). 3. Glio­ma ... on brain and spinal cord. 4. Myelomeningocele — the condition when the neutral tissue ... to the surface. 5. Will you be quiet, because the patient... .6. Many experiments ... that sleep is more necessary for the human being than food. 7. Blood vessels ... on account of high blood pressure. 8. Hemorrhage ... the nerve cells in the motor region of the cerebrum.

(a — can be checked up; b — protrudes; c — has just fallen asleep; d — have shown; e — can burst; f — can be characterized; g — damage; h — grows)

Task 17. Build medical terms:

1) ...thalamus; 2) lumber...; 3) ...phasia; 4) polioence- phal...; 5) multiple...; 6) electroencephalo...; 7) dys....

(a — ...itis; b - ...sclerosis; c — ...phasia; d — ...gram; e — a...; f — hypo...; g — ...puncture)

Task 18. Choose the proper terms for the definitions:

t. Removal of a “knot” (a mass) of nerve cells serving as a centre from which nerve impulses are transmitted. 2. Inflam­mations of a nerve often associated with a degenerative pro­cess and accompanied by changes in sensory and motor activity in the region of the affected nerve. 3. An acute inflammation of the membranes of the brain and spinal cord, caused by various microorganisms and characterized by fever, skin erup­tions, etc. 4. Disease of the white matter of the brain. 5. A total or partial loss of the power to use or understand words, inability to speak. 6. Inflammation of the spinal cord or the bone marrow. 7. A malignant tumour of the bone marrow, consisting generally of abnormal plasma cells. 8. A type of neurosis, usually the result of emotional conflicts characte­

rized by irritability, fatigue, weakness, anxiety, and, often, localized pains or distress without apparent physical causes.

6. A condition of abnormally increased muscular movement.

7. Excessive blood flow under the dura mater.

(a — neuritis; b — leukoencephalopathy; c — aphasia; d — subdural hematoma; e — myeloma; f — hyperkinesis (-ia); g — cerebrospinal meningitis; h — neurasthenia; і — myelitis; j — ganglionectomy)

Task 19. Fill in the blanks with the appropriate words given below:

1. The cerebrospinal... was normal. 2. An isolated abscess of the right cerebral... was found at necropsy. 3. The patient had constand bad ... and left ... . 4. A high measure of ... against .. can be given by prophylactic vaccination. 5. The left side of the body was ... . 6. Severely damaged nerve ... can be restored. 7. There are some effective methods against such grave disorders of the ... as Parkinson’s ....

(a — protection, poliomyelitis; b — paralyzed; c — headaches, hemiparesis; d — fibres; e — brain, disease; f — hemisphere; g — fluid)

Pharmaceutical Terms

Task 20. Memorize the following expressions before read­ing an extract from a direction to a medicine. They will help you to comprehend a direction better:

it exerts its therapeutic effect він виявляє свої ліку­вальні якості

to stimulate adrenocortical function сприяти виділенню гормонів кори надниркових залоз to have a direct influence on smth. безпосередньо впливати на щось

to yield better results than corticosteroids давати кращі результати ніж кортикостероїди (стероїдні гормони, що їх виділяє кора надниркових залоз) long-term treatment довготривале лікування the pituitary remains largely unaffected нижній мозковий придаток (гіпофіз) залишається в основному неураженим is administered by the intramuscular route вводиться внутрішньом ’язово

an acute exacerbation значне загострення (хвороби) retrobulbar (optic) neuritis ретробульбарний неврит

Guillain-Barre syndrome гострий первинний ідіопатичний по- лірадікулоневрит (синдром Гийєна-Барре, синдром Штроля) chorea minor [ko'ria 'mams] захворювання нервової системи людини, що характеризується мимовільним сіпанням, гримасами, причмокуванням slightly opalescent suspension мутнувата суспензія to give rise to side effects спричинити побічну дію to be part and parcel of smth. бути невід’ємною части­ною чогось

severe anaphylactic shock сильний анафілактичний шок (вид алергії)

Task 21. Memorize these equivalents. They will help you to understand the etymology of some medical terms:

Greek	Latin	English	Ukrainian
idio	proprius, a, um	own; individual	власний
narco	stupor, oris m	numbness, stupor оніміння
hypso	altitude, inis f	height	висота
tetra	quattuor	quater; four	чверть; чотири
porosis	porositas, atis f passage		прохід; канал
pneo,	spiratio, onis f	breathing	дихання
-pnea		round; circle
cyclo-	rotondus, a, um		круглий; круг
trias	très	three; thrice	три

Task 22. Read an extract from a direction to a medicine and get ready to answer the comprehension questions:

SYNACTHEN DEPOT

Properties. It exerts therapeutic effect chiefly by stimulating adrenocortical function. It is possible that Synacthen Depot may also have a direct influence on the central nervous tissues which might explain why the drug has been found to yield better results them corticosteroids in certain neurological disorders. Even during long-term treatment with Synacthen Depot the adrenal cortex continues to function efficiently and the pituitary remains largely unaffected. Absorption on to an inorganic zinc complex ensures protracted release of the active substance and thus a prolonged duration of action. Following an intramuscular injection of 1 mg. Synacthen Depot the plasma cortisol concentration remains elevated for 24 — 36 hours, but the clinical response usually persists for a longer time. Synacthen Depot is administered by the intra­muscular route; for intravenous use Synacthen is available.

Indications. Neurological diseases: acute exacerbations in patients suffering from multiple sclerosis, including retrobulbar neuritis; certain forms of polyneuritis, including especially Guillain-Barre syndrome (polyradiculo­neuritis); peripheral facial paralysis; infantile spasms with hypsarrhythmia; chorea minor; acute encephalitis; myasthenia gravis; cerebral oedema.

Contraindications. Absolute: hypersensitivity to tetracosac- tide, acute psychoses, infectious diseases (unless antibiotics are being administered at the same time), peptic ulcer, Cu­shing’s syndrome¹ and heart failure. Relative: Hypersensi­tivity to ACTH (adrenocorticotropic hormone)¹ of animal origin. Patients already receiving medication for diabetes mellitus or for moderate to severe hypertension must have their dosages readjusted if treatment with Synacthen Depot is instituted.

Pregnancy. Synacthen Depot is contraindicated during preg­nancy.

Dosage and administration. Adults: initially 1 mg. i.m. daily; in acute cases, as well as in patients with tumours, treatment can be started with 1 mg. every 12 hours. Once the acute manifestation have subsided, the usual dosage for the continuation of treatment is 1 mg. every 2 — 3 days; in pa­tients who respond well, it is often possible to reduce the dose to as little as 0.5 mg. every 2—3 days or 1 mg. weekly. Infants: initially 0.25 mg. i.m. daily: for maintenance purposes,

0. 25 mg. every 2—8days. Small children: initially 0.25 —

0. 5 mg. i. m. daily; for maintenance purposes, 0.25—0.5 mg. every 2—8days. Children of school age: initially 0.25 — 1 mg. i.m. daily; for maintenance purposes, 0.25—1 mg. eve­ry 2—8 days. The ampoule containing the relatively thin, slightly opalescent suspension should be shaken before use. The preparation should be stored in a refrigerator (2 — 8*C). Side effects. Synacthen Depot is liable to give rise to side effects which are part and parcel of the drug’s hormonal activity — e.g. sodium and water retension, elevation of blood pressure, hypokalaemia, hyperglycaemia, osteoporosis, Cushing’s syndrome, increased susceptibility to infection, psychic changes, peptic ulcers, and hyperpigmentation. Overdosage. In patients developing signs of water retention (increase in body weight) 6r of excessive adrenocortical ac­tivity (Cushing’s syndrome), Synacthen Depot should be with­drawn for a time or, alternatively, given in reduced doses either by halving the dosage or by prolonging the interval between injections to, say, 5 — 7 days.

Note. In rare cases — particularly in patients subject to asthma and/or other forms of allergy — severe anaphylactic shock reactions may occur. Such reactions set in usually within 30 minutes after administration of Synacthen Depot. Synac- then Depot should therefore be administered under medical supervision and the patient appropriately observed. The doc­tor should make every effort to find out whether the patient has a history of allergic disorders and whether, in particular, he has previously experienced adverse reactions to Synacthen or other drugs. In patients with a history of allergic disorders, including especially asthmatics, treatment with Synacthen Depot should be resorted to only if other therapeutic measures have failed to elicit the desired response and if the condition is severe enough to warrant such medication.

Anaphylactic reactions — can largely be avoided by discon­tinuing the treatment at the very first sign of any local or systemic hypersensitivity reaction. Reactions of this type in­clude: marked redness and pain at the injection site, urticaria, pruritis, flushing, severe malaise, or dyspnoea.

Storage. Protect from light and store in a refrigerator (2 — 8*C).

Packages. Ampoules containing 1 mg. and 0.5 mg. per ml. of suspension; vials of 2 ml. containing 2 mg.

Notes

'Cushing’s syndrome — a disorder of the adrenal cortex, characterized by obesity, hypertension, diabetes mellitus, etc.

³ ACTH (adrenocorticotropic hormone) — hormone which stimulates the outer section of the adrenal glads; it is secreted by the anterior lobe of the pituitary gland

Task 23. Answer the comprehension questions. Choose the answers below and comment upon a direction: daily; d — elevation of blood pressure; sodium and water retention, hypokalaemia, hyperglycaemia, osteoporosis, peptic ulcers, etc.; e — during treatment with Synacthen Depot the adrenal cortex continues to function efficiently and the pituitary remains largely unaffected; f — by the intramuscular route; g — adsorbtion on to an inorganic zinc complex)

Task 24. Try to memorize some pharmaceutical terms:

a one percent solution of purified sulfur однопроцентний розчин очищеної сірки peach oil персикове масло

overdoses of drugs надмірні дози лікарських препаратів a tranquilizer — any of certain drugs used as a calming agent in relieving and controlling various emotional disturbances, anxiety neuroses certain psychoses, etc. sedative — having the property of lessening excitement, nervousness, or irritation sleeping pills снотворні лікарські препарати (пілюлі, таблетки)

hypotensive drugs гіпотензивні лікарські препарати antidepressant — designating or of any drug used primarily to treat emotional depression serotonin — a chemical transmitter of nerve impulses; a com­plex amine found in blood, the brain, etc. or produces synthetically. It constricts the blood vessels and contracts smooth muscle tissue and is important in mental activity noxious dose ['nokfas] згубна доза

Task 25. Read a direction to a medicine Carbrital and get ready to answer the questions and comment upon it:

CARBRITAL

Sedative — Hypnotic

Indications. Sedative or hypnotic in insomnia, neurasthenia, hysteria, delirium tremens and psychoneuroses; general seda­tion in minor operations; in obstetrics to help produce amne­siac labor.

Contraindications. Hypersensitivity to barbiturates and/or carbomal; known previous addiction to sedative-hypnotics; porphyria; uncontrolled pain; history of confusion or restless­ness from hypnotics; history of abnormal reaction to barbitu­rates; severe pulmonary insufficiency; premonitory signs of hepatic coma.

Precautions. May be habit-forming. Should be used with caution in patients with severe impaired liver function, severe anemia, congestive heart failure, fever, neuroses, hyperthy­roidism, diabetes mellitus, and any conditions which respira­tory depression may be characteristic. Marked excitement rather than depression may occur in aged or debilitated patients, particularly those with cerebral arteriosclerosis. Confusion of euphoria may result if dosage is not adequate to produce sleep. Symptoms of mentally ill, phobic and emotionally dis­turbed patients may be accentuated. Prolonged usage may produce psychological habituation. Sudden discontinuation or radical reduction of dosage may precipitate withdrawal symp­toms in patients who have taken the drug for prolonged periods; dosage should be gradually reduced to the point of complete discontinuation.

Barbiturates should be prescribed with extreme caution for persons known or, suspected of routinely or periodically con­suming large quantities of alcoholic beverages. Potentiation of effect, even to the extent of causing death, may result from consumption of barbiturates by patients with high se­rum alcohol level.

Should be prescribed with great caution, or not at all, for persons with suicidal tendencies, a predilection for excessive use of medications, or the likelihood of becoming drug depen­dent. i

The effects of this product may be increased by many drugs, including antihistamines, tranquilizers, corticosteroids, MAO (monoamineoxidase) inhibitors, narcotic analgesics, amitripty­line, imipramine, and rauwolfia alkaloids.

A reduced efficacy and increase in incidence of breakthrough bleeding have been repotted in oral contraceptive users treated concomitantly with barbiturates.

Carbromal is metabolized in the body to yield free bromide ion. Accumulation of bromide as a result of prolonged use may result in the development of bromism.

Pregnancy and Lactation. Barbiturates readily cross the pla­cental barrier and if administered during labor may have a depressant effect on the fetus infants bom of mothers receiving barbiturates may have difficulty breathing spontaneously. Small ammounts of barbiturates are found in the milk of nursing mothers following large doses.

Adverse Effects. Allergic dermatoses, undue lassitude, vertigo, nausea, vomiting, diarrhea, headache, excitement, hangover and pain (myalgia, neuralgia, arthralgia), have been reported. Hypersensitivity reactions occur occasionally; they are more likely to appear in patients with asthma, urticaria, angio­neurotic edema. Jaundice is occasionally seen in patients who have become hypersensitive to barbiturates or who are suffering from barbiturate poisoning. Long continued use of this product could result in bromism which is characterized by numerous toxic manifestations such as impaired mental process; delirium; delusions; auditory and visual hallucinations; mania; loss of memory; drowsiness; disorientation; emotional disturbances; dermatitis; coma, tremors of the hands, lips, and tongue; speech defects and motor incoordination.

Dosage. Adults: 1 to 2 capsules before bedtime. Overdose. Treatment. In acute barbiturate toxicity, general physiologic supportive methods should be undertaken imme­diately. Most important of these is correction of anoxia, which may be accomplished by removal of airway obstruction, oxy­gen administration, artificial respiration, or a combination of these procedures. Absorption of the drug should be minimized by emesis, gastric lavage or gastric aspiration and administra­tion of activated charcoal. Peritoneal dialysis or hemodialysis may be life-saving in severe poisoning. Good nursing care is essential.

0. What are the indications of Carbrital? 2. What are contraindications of this medicine? 3. When may euphoria result? 4. For what persons should Carbrital be prescribed with great caution? 5. By what drugs may the effects of Carbrital be increased? 6. In what case may barbiturates have a depressant effect on the fetus? 7. What are the adverse effects of Carbrital? 8. What toxic manifestations is bromism characterized by? 9. What is the dosage of Carbrital for adults? 10. What are the general physiologic supportive methods for the correction of anoxya? 11. By what means can the absorption of the drug be minimized?

(a — headache, allergic dermatoses, hypersensitivity reac­tions, etc.; b — emesis, gastric lavages and administration of activated charcoal; c — removal of airway obstructions, artifi­cial respiration, etc.; d — tranquilizers, corticosteroids, narcotic analgesics, etc.; e — neurasthenia, insomnia, hysteria, delirium tremens, etc.; f — one to two capsules before bedtime; g — hypersensitivity to barbiturates, severe pulmonary insufficiency, etc.; h — if dosage is not adequate to produce sleep; i — impaired mental process, auditory and visual hallucinations, etc. ; j — persons with suicidal tendencies or who can become drug dependent; k — if barbiturates are administered during labor)

Task 26. Read the dictionary articles and get ready to answer the comprehension questions:

Aminazin

(from SBD)

The Russian name for chlorpromazine (Thorazine), a sedative used especially in the treatment of mental illness.

Fainberg was given injections of aminazin, known in English as Thora­zine, another anti psychotic drug, which makes a normal person sleepy and groggy, practically turning him into a vegetable if administered in sufficient quantities.

Sulfazin (Sulphazin)

(from SBD)

A drug administered in Soviet psychiatric hospitals to treat mental illness and allegedly as a punishment. It consists of one-percent solution of purified sulfur in peach oil and it induces fever, weight loss, and exhaustion.

If a patient speakcs out against such brutality, he is subjected to punish­ment by overdoses of drugs or injections of sulfazin that.make it painful for him even to stir ...

Anxiolytic

(from SBD)

A drug used to relieve anxiety: a tranquilizer.

Physicians no less than patients, says Dr. Shapiro, have always been, and still are, subject to fads and fashions in medicines, and the anxiolitics arc today's “in” drugs.

Tricyclic

(from SBD)

Any of a class of antidepressant drugs that prevent the breakdown of serotonin, a chemical transmitter of nerve impul­ses believed to be involved in depression.

Tricyclics antidepressants help the people who get to sleep, but wake up at about three, seeing everything as a disaster; their mortgage is going to fall in, they're going to lose their job, their daughter is going to marry

the wrong man, their wife’s going to leave them ... You want to give them tricyclics at night sufficient to stop this early-morning waking, this early-morning panic.

This medicine is so called from the drugs being tricyclic compounds (having a three-ringed molecular structure).

Task 27. Choose the possible answers to the compre­hension questions:

1. What type of medicine is aminazin? 2. In the treatment of what disease can aminazin be used? 3. What is the effect of aminazin? 4. What are the ingredients of sulfazin? 5. What does sulfazin induce? 6. What type of medicine is anxiolytic?

7. What is the function of serotonin? 8. What type of medi­cine is tricyclic? 9. What does tricyclic prevent? 10. What is tricyclic involved in?

(a — fever, weight loss and exhaustion; b — a tranquilizer; c — antidepressant; d — the breakdown of serotonin; e — in depression; f — a chemical transmitter of nerve impulses; g — of mental illness; h — it makes a normal person feel sleepy and groggy; i — a one-percent solution of purified sulfur in peach oil; j — a sedative, antipsychotic, neuroleptic one)

Task 28. Choose the proper terms for the definitions:

1. Hypersensitive reaction to a drug or foreign organism.

0. A toxic harmful effect as a result from the use of drugs.

1. This injection is given into the muscle. 4. Factors in a patient’ condition which make the use of a drug dangerous and ill advised. 5. An acute allergic reaction to a drug. 6. Drugs which decrease the functioning of an organ or system. 7. Those drugs which effect the nervous system. 8. Central nervous system depressants which relax and quiet a patient without producing sleep.

(a — anaphylaxis; b — side effect; c — intramuscular (i. m.); d — contraindications; e — anaphylactic shock; f — depressants; g — sedatives; h — neuropharmacologic drugs)

Task 29. Fill in the blanks with the appropriate words given below:

1. Agents which decrease the functioning of an ... or sys­tem (depressants). 2. Drugs which alter ... and control ... such as depression, fears, etc. (tranquilizers). 3. Drugs which

... sleep (hypnotic). 4. Drugs which depress the

(sedatives). 5. Chemical produced normally at all times by ... endings (acetylcholine). 6. Chemical released by the ... glands (epinephrine). 7. Analgesics are agents which act to relieve ... .8. Narcotic analgesics are codeine ... opium. 9. Hypnotic drugs are those which depress the central nervous system and produce ... . 10. Side effects of caffeine, which is obtained from ... leaves ... beans are tachycardia and irritability, as well as insomnia.

(a — produce; b — nerve; c — adrenal; d — organ; e — pain; f — morphine; g — sleep; h — behaviour, symptoms; і — tea, coffee; j — central nervous system)

Task 30. Study the meaning of the following expres­sions from the extract from Somerset Maugham’s short story “Lord Mountdrago”, then read it and do some con­solidation tasks:

to do smb. a serious injury завдати комусь серйозної душев­ної травми

to feel qualms відчувати докори сумління to let smb. down підвести когось у якійсь справі to seek by suggestion to make smb. forget smth. шукати можливостей примусити когось забути щось за допомогою сугестії (навіювання) to break down smb’s resistance подолати чийсь опір the frightful dreams кошмарні сни to harass smb. турбувати когось

irritability was uncontrollable дратівливість була без­контрольною

to receive benefit from smth. мати вигоду з чогось to come to the conclusion дійти висновку to save smb. from the breakdown врятувати когось від нервового розладу to find smb. susceptible to smth. встановити, що хтось піддається навіюванню to get smb. into a condition of somnolence довести когось до сонного стану to soothe smb’s nerves заспокоїти чиїсь нерви to relax one’s limbs розслабити кінцівки whatever lies in smb’s power все, що в чиїхось силах to undo the harm загладити провину (образу) to act like a blow of whip подіяти наче удар батогом to shake oneself out of hypnotic state різко прокинутися від гіпнотичного стану to spring to one’s feet скочити на ноги to use language of obscenity вживати лайливу лексику a condition of uncontrollable fury стан неопанованого гніву to foam at the mouth піна летить з рота waiting for the storm to wear itself out очікуючи, доки буря гніву вщухне to have a notion that... бути переконаним, що ... to regret nothing ні про що не шкодувати his usual methods of treatment had failed його звичайні методи лікування виявилися неефективними

Task 31. Read the text and get ready to narrate it:

LORD MOUNTDRAGO by W. S. Maugham

(an extract)

“Should I be putting it too strongly if I said you had ruined his career?” asked Dr. Audlin.

“I don’t suppose you would."

“That is a very serious injury you’ve done him.”

“He brought it on himself.”

“Have you never felt any qualms about it?”

“I think perhaps if I’d known that his father and mother were there I might have let him down a little more gently.” There was nothing further for Dr. Audlin to say, and he set about treating his patient is such a manner as he thought might avail. He sought by suggestion to make him forget his dreams when he awoke; he sought to make him sleep so deeply that he would not dream. He found Lord Mountdrago’s resistance impossible to break down. At the end of an hour he dismissed him. Since then he had seen Lord Mountdrago half a dozen times. He had done him no good. The frightful dreams continued every night to harass the unfortunate man, and it was clear that his general condition was growing rapidly worse. He was worn out. His irritability was uncontrollable. Lord Mountdrago was angry because he received no benefit from his treatment, and yet continued it, not only because it seemed his only hope, but because it was a relief to him to have someone with whom he could talk openly. Dr. Audlin came to the conclusion at last that there was only one way in which Lord Mountdrago could achieve deliverance, but he knew him well enough to be assured that of his own free will he would never, never take it. If Lord Mountdrago was to be saved from the breakdown that was threatening he must be induced to take a step that must be abhorrent to his pride of birth and his self-complacency. Dr. Audlin was convinced that to delay was impossible. He was treating his patient by suggestion, and after several visits found him more susceptible to it. At length he managed to get him into a condition of somnolence. With his low, soft, monotonous voice he soothed his tortured nerves. He repeated the same words over and over again. Lord Mountdrago lay quite still, his eyes closed; his breathing was regular, and his limbs were relaxed! Then Dr. Audlin in the same quiet tone spoke the words he had prepared.

“You will go to Owen Griffiths and say that you are sorry that you caused him that great injury. You will say that you will do whatever lies in your power to undo the harm that you have done him.”

The words acted on Lord Mountdrago like the blow of a whip across his face. He shook himself out of his hypnotic sta­te and sprang to his feet. His eyes blazed with passion and he poured forth upon Dr. Audlin a stream of angry vituperation such as even he had never heard. He swore at him. He cursed him. He used language of such obscenity that Dr. Audlin, who had heard every sort of foul word,sometimes from the li ps of chaste and distinguished women, was surprised that he knew it.

“Apologize to that filthy little Welshman? I’d rather kill myself." “I believe it to be the only way in which you can regain your balance."

Dr. Audlin had not often seen a man presumably sane in such a condition of uncontrollable fury. He grew red in the face and his eyes bulged out of his head. He did really foam at the mouth. Dr. Audlin watched him coolly, waiting for the storm to wear itself out, and presently he saw that Lord Mountdrago, weakened by the strain to which he had been subjected for so many weeks, was exhausted.

“Sit down,” he said then, sharply.

Lord Mountdrago crumpled up into a chair.

“Christ, I feel all in. I must rest a minute and then I’ll go.” For five minutes perhaps they sat in complete silence. Lord Mountdrago was a gross, blustering bully, but he was also a gentleman. When he broke the silence he had recovered his self-control.

“I’m afraid I’ve been very rude to you. I’m ashamed of the things I’ve said to you and I can only say you’d be justified if you refused to have anything more to do with me. I hope you won’t do that. I feel that my visits to you do help me. I think you are my only chance.”

“You mustn’t give another thought to what you said. It was of no consequence.”

“But there’s one thing you mustn’t ask me to do, and that is to make excuses to Griffiths.”

"I’ve thought a great deal about your case. I don’t pretend to understand it, but I believe that your only chance of release is to do what I proposed. I have a notion that we’re none of us one self, but many, and one of themselves in you has risen up against the injury you did Griffiths and has taken on the form of Griffiths in your mind and is punishing you for what you cruelly did. If I were a priest I should tell you that it is your conscience that has adopted the shape and lineaments of this man to scourge you to repentance and persuade you to reparation.”

“My conscience is clear. It’s not my fault if I smashed the man’s career. I crushed him like a slug in my garden. I regret nothing.”

It was on these words that Lord Mountdrago had left him. Reading through his notes, while he waited, Dr. Audlin con­sidered how best he could bring his patient to the state of mind that, now that his usual methods of treatment had failed, he thought alone could help him.

Task 32. Find proofs in the extract that:

1. Dr. Audlin sought by suggestion to make Lord Mountdra­go forget his dreams. 2. Dr. Audlin’s methods had done Lord Mountdrago no good. 3. Lord Mountdrago’s condition was growing rapidly worse. 4. Lord Mountdrago had to be induced to take a step that must be abhorrent to his pride of birth.

5. Dr. Audlin soothed Lord Mountdrago’s tortured nerves. 6. Dr. Audlin’s words acted on Lord Mountdrago like the blow of a whip across his face. 7.Lord Mountdrago was a gentleman.

Task 33. Choose the opposites:

1) to awake; 2 ) worse; 3) deliverance; 4) to delay; 5) som­nolence; 6) to forget; 7) to manage; 8) to stop; 9) to find; 10) weakly;

(a — to loose; b — to hurry; c — strongly; d — to continue; e — to fail; f — vigilance; g — acquisition (gain); h — better; i — to remember; j — to fall asleep)

Task 34. Find in the text the description of:

1. Dr. Audlin’s manner of treating his patient. 2. Lord Mountdrago’s condition of somnolence. 3. Lord Mountdra­go’s actions when he shook himself out of his hypnotic state.

0. A condition of uncontrollable fury. 5. Dr. Audlin’s notion that we are none of us one self, but many.

Task 35. Choose the correct ending of the sentences:

1. Dr. Audlin was sure that Lord Mountdrago ... 2. It was clear that Lord Mountdrago’s condition ... 3. Lord Mountdrago

was angry because ... 4. Reading through his notes Dr. Audlin ... 5.1 am ashamed of... 6. Dr. Audlin watched Lord Mountdra­go cooly, waiting for ... 7. Lord Mountdrago poured forth upon Dr. Audlin a stream of ... 8. The words acted on Lord Mountdrago like ... 9. You will say that you will do whatever lies in your power ... 10. Dr. Audlin believed that Lord Mountdrago’s chance of release is ...

(a — he received no benefit from his treatments; b — considered how best he could help him; c — the thing I have said to you; d — had a ruined Owen Griffiths’ career; e — the blow of a whip across his face; f — to undo the harm that you have done Owen Griffiths; g — to do what he had proposed; h — angry vituperation; i — the storm to wear itself out; j — was growing rapidly worse)

Keys

Task 4. 1 — f; 2 — a; 3 — b; 4 — c; 5 - d; 6 — c; 7 — h; 8 — g;

9 - i; 10 - j.

Task S. 1 — f; 2 — a; 3 — b; 4 — c; 5 - g; 6 — c; 7 — d; 8 — j; 9 - i; 10 - h.

Task 6. 1 — i; 2 — f; 3 — a; 4 — b; 5 — c; 6 — d; 7 — e; 8 — g;

9 - h; 10 - i.

Task 8. 1 — g; 2 — a; 3 — f; 4 — c; 5 — b; 6 — c; 7 — d.

Task 12. 1 - f; 2 - a; 3 - j; 4 - b; 5 - c; 6 - i; 7 - h; 8 - d; 9 - e; 10 - g.

Task 14. 1 — e; 2 — f; 3 - a; 4 — b; 5 — j; 6 — i; 7 — c; 8 — d; 9 - g; 10 - h.

Task 16. 1 — f; 2 — a; 3 — h; 4 — b; 5 — c; 6 — d; 7 — c; 8 — g.

Task 17. 1 - f; 2 - g; 3 - c; 4 - a; 5 - b; 6 - d; 7 - c.

Task 18. t — j; 2 — a; 3 — g; 4 — b; 5 — c; 6 — i; 7 — e; 8 — h; 9 - f; 10 - d.

Task 19. 1 - g; 2 - f; 3 - c; 4 - a; 5 - b; 6 - d; 7 - c.

Task 23. 1 - e; 2 - g; 3 - f; 4 - a; 5 - b; 6 - c; 7 - d.

Task 25. 1 - e; 2 - g; 3 - h; 4 - j; 5 - d; 6 - k; 7 - a; 8 - i; 9 - f; 10 - c; 11 - b.

Task 27. 1 - j; 2 - g; 3 - h; 4 - i; 5 - a; 6 - b; 7 - f; 8 - c; 9 — d; 10 — c.

Task 28. 1 — d; 2 — b; 3 — c; 4 — a; 5 — e; 6 — f; 7 — h; 8 — g.

Task 29. 1 - d; 2 - h; 3 - a; 4 - j; 5 - b; 6 - c; 7 - c; 8 - f;

9 - g; 10 - i.

Task 33- 1 — j; 2 — h; 3 — g; 4 — b; 5 — f; 6 — i; 7 — c; 8 — d;

9 — a; 10 — c.

Task 35. 1 - d; 2 - j; 3 - a; 4 - b; 5 - c; 6 - i; 7 - h; 8 - c;

9 - f; 10 - g