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to regard it as tantamount to charge of charlatanism, In fact, the placebo effect is a powerful part of all medical care, orthodox or otherwise, though its role is often neglected and misunderstood.
One of the great strengths of CAM may be its practioners‘ skill in deploying the placebo effect to accomplish real healing. ―Complementary practitioners are miles better at producing non-specific effects and good therapeutic relationships,‖ says Edzard Ernst, professor of CAM at Exeter University. The question is whether CAM could be integrated into conventional medicine, as some would like, without losing much of this power.
At one level, it should come as no surprise that our state of mind can influence our physiology: anger opens the superficial blood vessels of the face; sadness pumps the tear glands.
But exactly how placebos work their medical magic is still largely unknown. Most of the scant research to date has focused on the control of pain, because it‘s one of the commonest complaints and lends itself to experimental study. Here, attention has turned to the endorphins natural counterparts of morphine that are known to help control pain. ―Any of the neurochemicals involved in transmitting pain impulse or modulating them might also be involved in generating the placebo response,‖ says Don Price, an oral surgeon at the University of Florida who studies the placebo effect in dental pain.
―But endorphins are still out in front.‖ That case has been strengthened by the recent work of Fabrizio Benedetti of Turin, who showed that the placebo effect can be abolished by a drug naloxone, which blocks the effects of endorphins. Benedetti induced pain in human volunteers by inflating a blood-pressure cuff on the forearm. He did this several times a day for several days, using morphine each time to control the pain. On the final day, without saying anything, he replaced the morphine with a saline solution. This still relieved the subjects‘ pain: a placebo effect. But when he added naloxone to the saline the pain relief disappeared. Here was direct proof that placebo analgesia is mediated, at least in part, by these natural opiates.
Still, no one knows how belief triggers endorphin release, or why most people can‘t achieve placebo pain relief simply by willing it. Though scientists don‘t know exactly how placebos work, they have accumulated a fair bit of knowledge about how to trigger the effect. A London rheumatologist found, for example, that red dummy capsules made more effective painkillers than blue, green or yellow ones. Research on American students revealed that blue pills make a difference: if Aspro or Tylenol are what you like to take for a headache, their chemically identical generic equivalents may be less effective.
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It matters, too, how the treatment is delivered. Decades ago, when the major tranquilliser chlorpromazine was being introduced, a doctor in Kansas categorized his colleagues according to whether they were keen on it, openly skeptical of its benefits, or took a ―let‘s try and see‖ attitude. His conclusion: the more enthusiastic the doctor, the better the drug performed. And this year Ernst surveyed published studies that compared doctors‘ bedside manners. The studies turned up one consistent finding: ―Physicians who adopt a warm, friendly and reassuring manner,‖ he reported, ―are more effective than those whose consultations are formal and do not offer reassurance.‖
Warm, friendly and reassuring are precisely CAM‘s strong suits, of course. Many of the ingredients of that opening recipe—the physical contact, the generous swathes of time, the strong hints of supernormal healing power—are just the kind of thing likely to impress patients. It‘s hardly surprising, then, that complementary practitioners are generally best at mobilizing the placebo effect, says Arthur Kleinman, professor of social anthropology at Harvard University.
Questions 27-32
Complete the following sentences with the correct ending. Choose the correct letter, A-H, for each sentence below.
Write your answers in boxes 27-32 on your answer sheet.
27 Appointments with alternative practitioner
28 An alternative practitioner‘s description of treatment 29 An alternative practitioner who has faith in what he does 30 The illness of patients convinced of alternative practice 32 Conventional medical doctors
Questions 33-35
A should be easy to understand. B ought to improve by itself. C should not involve any mysticism. D ought to last a minimum length of time. E needs to be treated at the right time. F should give more recognition. G can earn high income. H do not rely on any specific treatment. I will persist until I succeed!
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Choose the correct letter, A,B,C or D.
Write your answers in boxes 33-35 on your answer sheet.
33 In the fifth paragraph, the writer uses the example of anger and sadness to illustrate that
A people‘s feelings could affect their physical behavior. B how placebo achieves its effect is yet to be understood. C scientists don‘t understand how the mind influences the body. D research on the placebo effect is very limited.
34 Research on pain control attracts most of the attention because A only a limited number of researches have been conducted so far. B scientists have discovered that endorphins can help reduce pain. C pain reducing agents might also be involved in placebo effect. D patients often experience pain and like to complain about it.
35 Fabrizio Benedetti‘s research on endorphins indicates that A they are widely used to regulate pain. B they can be produced by willful thoughts. C they can be neutralized by introducing naloxone. D their pain-relieving effects of not last long enough.
Questions 36-40
Do the following statements agree with the information given in Reading Passage 3? In boxes 36-40 on your answer sheet, write
TRUE if the statement agrees with the information FALSE if the statement contradicts the information NOT GIVEN if there is on information on this
36 There is enough information for scientists to fully understand the placebo effect. 37 A London based researcher discovered that red pills should be taken off the market.
38 People‘s reference on brands would also have effect on their healing.
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39 Medical doctors have a range of views of the newly introduced drug of chlorpromazine.
40 Alternative practitioners are seldom known for applying placebo effect.
READING PASSAGE 9
文章背景： 笑的根源。有位科学家为了研究笑的起源所以将人类和大猩猩的笑作了比较，发现两者是不一样的。又将大猩猩的笑和小婴儿进行了比对发现其模式相似。 灵长类动物（primates）很多都有笑的功能。虽然我们依然不能对笑的起源做出合理的解释，但有一点是肯定的，那就是原始的人类发笑绝对不是因为史前的笑话而笑（prehistoric joke）.笑一定是潜藏在我们生物机体中的一种本能反应。
You should spend about 20 minutes on Questions 1-13 which are based on Reading Passage 1 below.
The origins of Laughter
While joking and wit are uniquely human inventions, laughter certainly is not. Other creatures, including chimpanzees, gorillas and even rats, laugh. The fact that they laugh suggests that laughter has been around for a lot longer than we have.
There is no doubt that laughing typically involves groups of people. ―Laughter evolved as a signal to others — it almost disappears when we are alone,‖ says Robert Provine, a neuroscientist at the University of Maryland. Provine found that most laughter comes as a polite reaction to everyday remarks such as ―see you later‖, rather than anything particularly funny. And the way we laugh depends on the company we‘re keeping. Men tend to laugh longer and harder when they are with other men, perhaps as a way of bonding. Women tend to laugh more and at a higher pitch when men are present, possibly indicating flirtation or even submission.
To find the origins of laughter, Provine believes we need to look at play. He points out that masters of laughing are children, and nowhere is their talent more obvious than in the boisterous antics, and the original context is play. Well-know primate watchers, including Dian Fossey and Jane Goodall, have long argued that chimps laugh while at play. The sound they produce is known as a pant laugh. It seems obvious when you watch their behavior — they even have the same ticklish spots as we do. But after removing the context, the parallel between human laughter and a chimp‘s characteristic pant laugh is not so clear. When Provine played a tape of the pant laughs to 119 of his students, for example, only two guessed correctly what it was.
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These findings underline how chimp and human laughter vary. When we laugh the sound is usually produced by chopping up a single exhalation into a series of shorter with one sound produced on each inward and outward breach. The question is: does this pant laughter have the same source as our own laughter? New research lends weight to the idea that it does. The findings come from Elke Zimmerman, head of the Institute for Zoology in Germany, who compared the sounds made by babies and chimpanzees in response to tickling during the first year of their life. Using sound spectrographs to reveal the pitch and intensity of vocalizations, she discovered that chimp and human baby laughter follow broadly the same pattern. Zimmerman believes the closeness of baby laughter to chimp laughter supports the idea that laughter was around long before humans arrived on the scene. What started simply as a modification of breathing associated with enjoyable and playful interactions has acquired a symbolic meaning as an indicator of pleasure.
Pinpointing when laughter developed is another matter. Humans and chimps share a common ancestor that lived perhaps 8 million years ago, but animals might have been laughing long before that. More distantly related primates, including gorillas, laugh, and anecdotal evidence suggests that other social mammals can do too. Scientists are currently testing such stories with a comparative analysis of just how common laughter is among animals. So far, though, the most compelling evidence for laughter beyond primates comes from research done by Jaak Panksepp from Bowling Green State University, Ohio, into the ultrasonic chirps produced by rats during play and in response to tickling.
All this still doesn‘t answer the question of why we laugh at all. One idea is that laughter and tickling originated as a way of sealing the relationship between mother and child, Another is that the reflex response to tickling is protective, alerting us to the presence of crawling creatures that might harm us or compelling us to defend the parts of our bodies that are most vulnerable in hand-to –hand combat. But the idea that has gained the most popularity in recent years is that laughter in response to tickling is a way for two individuals to signal and test their trust in one another. This hypothesis starts from the observation that although a little tickle can be enjoyable, if it goes on too long it can be torture. By engaging in a bout of tickling, we put ourselves at the mercy of another individual, and laughter is what makes it a reliable signal of trust, according to Tom Flamson, a laughter researcher at the University of California, Los Angels. ―Even in rats, laughter, tickle, play and trust are linked. Rats chirp a lot when they play,‖ says Flamson. ―These chirps can be aroused by tickling. And they get bonded to us as a result, which certainly seems like a show of trust.‖
We‘ll never know which animal laughed the first laugh, or why. But we can be sure it wasn‘t in response to a prehistoric joke. The funny thing is that while the origins of laughter are probably quit serious, we owe human laughter and our language-based humor to the same unique skill. While other animals pant, we alone can control our
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