【中英⽂对照】奥利弗·萨克斯（OliverSacks）：从幻觉认识我们的⼼智
从幻觉认识
我们的⼼智
视频
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TED 指Technology, Entertainment, Design在英语中的缩写，即技术、娱乐、设计。
TED 是美国的⼀家私有⾮营利机构，该机构以它组织的TED⼤会著称。每年，TED⼤会在美国召集众多科学、设计、⽂学、⾳乐等领域的杰出⼈物，分享他们关于技术、社会、⼈的思考和探索。 TED⼤会希望传达这样⼀个的信息，即优秀的思想可以改变⼈们对这个世界的看法，使⼈们反思⾃⼰的⾏为。
在本次TED演讲中，奥利弗·萨克斯（Oliver Sacks）教授带我们认识邦奈特症候群，也就是视⼒受损的⼈产⽣鲜明幻觉。他⽤温馨的细节描述了病⼈的经历，并以这样的叙述让我们了解这种鲜少被报道的现象背后的⽣理原理。
奥利弗·萨克斯（Oliver Sacks）教授是⼀位神经学家和作家，⽼⼈家做此讲座时，80⾼寿依然思维敏捷，精神矍铄，对答如流。真⼼赞！
cue是什么意思
我们⽤眼睛看东西，但也⽤脑看东西。⽤脑看就是所谓的想象。我们很熟悉⾃⼰的想象世界是什么样貌，那是我们的
我们⽤眼睛看东西，但也⽤脑看东西。⽤脑看就是所谓的想象。我们很熟悉⾃⼰的想象世界是什么样貌，那是我们的本质，⼀辈⼦跟着我们。但此外还有⼀种东西是幻觉。幻觉就截然不同了。幻觉不像是我们创造出来的，似乎不受我们控制，好像是从外⾯来的，然后伪装成知觉。
We e with the eyes, but we e with the brain as well. And eing with the brain is often called imagination. And we are familiar with the landscapes of our own imagination, our inscapes. We've lived with them all our lives. But there are also hallucinations as well, and hallucinations are completely different. They don't em to be of our creation. They don't em to be under our control. They em to come from the outside, and to mimic perception.
我今天要讲的就是幻觉。⽽且是我在病患⾝上看到的⼀种特殊的视觉幻觉。⼏个⽉前，我接到⼀通电话。是我服务的赡养院打来的。他们说院⾥有⼀位90⼏岁的⽼太太出现了幻视。他们不知道她是疯了呢？还是说，因为她是⽼太太，也许她中风了，或者得了阿兹海默⽒症。
So I am going to be talking about hallucinations, and a particular sort of visual hallucination which I e among my patients. A few months ago, I got a phone call from a nursing home where I work. They told me that one of their residents, an old lady in her 90s, was eing things, and they wondered if she'd gone bonkers or, becau she was an old lady, whether she'd had a stroke, or whether she had Alzheimer's.
所以他们问我能不能来看⼀下罗莎莉，也就是这位⽼太太。我去探视她，马上就看得出来她的⼼智很正常，神智清楚，也很聪明。但是她很惊慌、很困惑，因为她出现了幻视。她跟我说，这⼀点护⼠没提到，她是盲⼈。她因为黄斑病变，已经完全失明5年了。可是，这⼏天却开始看到东西。
And so they asked me if I would come and e Rosalie, the old lady. I went in to e her. It was evident straight away that she was perfectly sane and lucid and of good intelligence, but she'd been very startled and very bewildered, becau she'd been eing things. And she told me -- the nurs hadn't mentioned this -- that she was blind, that she had been completely blind from macular degeneration for five years. But now, for the last few days, she'd been eing things.
hobby是什么意思我就说：「什么样的东西？」她说：穿东⽅服饰、穿袍⼦的⼈⾛楼梯上上下下。⼀个男的转⾝对我微笑，但他脸上有⼀边的⽛齿⾮常巨⼤。也会看到动物。我看到⼀栋⽩⾊建筑。下着⼀点雪。我看到⼀匹上了马鞍的马，把雪拖⾛。后来有天晚上，场景变了。我看到很多猫跟狗⾛向我，⾛到⼀个地⽅就停住，然后场景⼜变了。我看到很多⼩孩，上上下下地⾛楼梯。他们穿着鲜艳的玫瑰⾊跟蓝⾊，像是东⽅服饰。
So I said, "What sort of things?" And she said, "People in Eastern dress, in drapes, walking up and down stairs. A man who turns towards me and smiles. But he has huge teeth on one side of his mout
h. Animals too. I e a white building. It's snowing, a soft snow. I e this hor with a harness, dragging the snow away. Then, one night, the scene changes. I e cats and dogs walking towards me. They come to a certain point and then stop. Then it changes again.
I e a lot of children. They are walking up and down stairs. They wear bright colors, ro and blue, like Eastern dress."
她说，有时候在这些⼈物出现之前，她会出现幻视，看到地板上有粉红⾊跟蓝⾊⽅块，⼀路连到天花准考证号码查询
板上。我说，这像是做梦吗？她说，不像做梦，像电影。有颜⾊，有动作，但是完全没有声⾳，像是哑剧。她说，⽽且是挺⽆聊的电影。⼀堆穿着东⽅服饰的⼈⾛上⾛下，⼀直重复，没什么变化。
Sometimes, she said, before the people come on, she may hallucinate pink and blue squares on the floor, which em to go up to the ceiling. I said, "Is this like a dream?" And she said, "No, it's not like a dream. It's like a movie." She said, "It's got color. It's got motion. But it's completely silent, like a silent movie." And she said that it's a rather boring movie. She said, "All the people with Eastern dress, walking up and down, very repetitive, very limited."
hump她很幽默，她知道那是幻视，但是她很害怕。她活到95岁了，以前从没出现过幻觉。她说这些幻觉跟她的思考感觉或动作完全不相关。幻视好像凭空出现，或凭空消失，她没办法控制。幻视中出现的⼈或地点她都不认得。⽽这些⼈或动物，似乎也都⽆视于她的存在。她不知道这是怎么⼀回事，不知道⾃⼰是发疯了，还是神智不清了。
And she has a n of humor. She knew it was a hallucination. But she was frightened. She'd lived 95 years and she'd never had a hallucination before. She said that the hallucinations were unrelated to anything she was thinking or feeling or doing, that they emed to come on by themlves, or disappear. She had no control over them. She said she didn't recognize any of the people or places i
n the hallucinations. And none of the people or the animals, well, they all emed oblivious of her. And she didn't know what was going on. She wondered if she was going mad or losing her mind.
我仔细地帮她检查。她是⼀位聪明的⽼太太。⼼智完全正常，没有什么病症，没有服⽤可能导致幻觉的药物。但是她失明了。于是我就跟她说：「我想我知道你得了什么病。」我说，这是⼀种特殊的幻视，常伴随视⼒恶化或失明出现。这种症状最早的纪录，是在18世纪，由⼀位查尔⼠•邦奈特最先发现的。你有邦奈特症候群，你的⼤脑没问题，⼼智没问题，你得的是邦奈特症候群。
Well, I examined her carefully. She was a bright old lady, perfectly sane. She had no medical problems. She wasn't on any medications which could produce hallucinations. But she was blind. And I then said to her, "I think I know what you have." I said, "There is a special form of visual hallucination which may go with deteriorating vision or blindness. This was originally described," I said, "right back in the 18th century, by a man called Charles Bonnet. And you have Charles Bonnet syndrome. There is nothing wrong with your brain. There is nothing wrong with your mind. You have Charles Bonnet syndrome."
她听了就放⼼了，还好不是什么严重的病。同时她也很好奇。她说：「查尔⼠•邦奈特是谁？」他⾃⼰有这个症状群吗？然后她说，去跟所有的护⼠说，我有邦奈特症候群。我没发疯，不是精神失常，我有邦奈特症候群。我也的确跟所有的护⼠说了。
And she was very relieved at this, that there was nothing riously the matter, and also rather curious. She said, "Who is this Charles Bonnet?" She said, "Did he have them himlf?" And she said, "Tell all the nurs that I have Charles Bonnet syndrome." "I'm not crazy. I'm not demented. I have Charles Bonnet syndrome." Well, so I did tell the nurs.
这对我来说是常见的情况。我主要在⽼⼈院服务，我有很多⽼⼈病患他们听⼒或视⼒受损。听⼒受损的⼈当中约有10% 出现⾳乐的幻听。视⼒受损的⼈当中约有10% 出现幻视。不⼀定要全盲，视⼒受损到⼀定程度就有可能。slqq
Now this, for me, is a common situation. I work in old-age homes, largely. I e a lot of elderly people who are hearing impaired or visually impaired. About 10 percent of the hearing impaired people get musical hallucinations. And about 10 percent of the visually impaired people get visual hallucinations. You don't have to be completely blind, only sufficiently impaired.
说到18世纪对这症候群的描述，查尔⼠•邦奈特本⼈没有这个症候群，是他的外祖⽗有。他的外祖⽗是⼀位地⽅官员，年纪很⼤了。他动过⽩内障⼿术，视⼒⾮常差。 1759年，他把他所看到的幻视描述给外孙听。
Now with the original deion in the 18th century, Charles Bonnet did not have them. His grandfather had the hallucinations. His grandfather was a magistrate, an elderly man. He'd had cataract surgery. His vision was pretty poor. And in 1759, he described to his grandson various things he was eing.
⾸先他说他看到⼀条⼿帕浮在半空中。⼀条蓝⾊的⼤⼿帕，上⾯有四个橘⾊圆圈。他知道那是幻视，⼿帕不会浮在半空中。然后他看到⼀个⼤轮⼦浮在半空中。但有时他不太确定到底是不是幻觉，因为幻觉会符合他的视觉情境。有⼀次，外孙⼥来看他，他说，跟妳⼀起来的这些英俊⼩伙⼦是谁呀？家⼈说，外公，没有什么英俊⼩伙⼦呀。然后英俊⼩伙⼦就消失了。这类幻视的⼀个特⾊是会凭空出现，凭空消失。通常不是淡⼊淡出，⽽是很突然的，⽽且会⼀下⼦改变。
The first thing he said was he saw a handkerchief in midair. It was a large blue handkerchief with four orange circles. And he knew it was a hallucination. You don't have handkerchiefs in midair. And then he saw a big wheel in midair. But sometimes he wasn't sure whether he was hallucinating or not, becau the hallucinations would fit in the context of the visions. So on one occasion, when his granddaughters were visiting them, he said, "And who are the handsome young men with you?" And they said, "Alas, Grandpapa, there are no handsome young men." And then the handsome young men disappeared. It's typical of the hallucinations that they may come in a flash and disappear in a flash. They don't usually fade in and out. They are rather sudden, and they change suddenly.
查尔⼠•卢兰，这位外祖⽗看到⼏百个不同的⼈物，各式各样的景⾊。有⼀次他看到⼀个男的穿著浴袍抽烟⽃，结果发现那是他⾃⼰。那是他唯⼀认得的⼈物。有⼀次他⾛在巴黎街头，他看到真的鹰架，
专科生可以考研吗但回到家以后，他看到鹰架的缩⼩版， 6吋⾼的鹰架出现在他书桌上。这种重复出现的知觉，有时候叫做视觉重复。
Charles Lullin, the grandfather, saw hundreds of different figures, different landscapes of all sorts. On one occasion, he saw a man in a bathrobe smoking a pipe, and realized it was himlf. That was the only figure he recognized. On one occasion when he was walking in the streets of Paris, he saw -- this was real -- a scaffolding. But when he got back home, he saw a miniature of the scaffolding six inches high, on his study table. This repetition of perception is sometimes called palinopsia.
他跟罗莎莉经验到的... 罗莎莉也问，这是怎么回事？我说，当视觉恶化，脑中负责视觉的部分再也收不到刺激，就变得特别活跃，特别容易被激发，开始⾃发性的活跃起来，幻视就出现了。幻视的内容可能⾮常复杂。
With him and with Rosalie, what ems to be going on -- and Rosalie said, "What's going on?" -- and I said that as you lo vision, as the visual parts of the brain are no longer getting any input, they become hyperactive and excitable, and they start to fire spontaneously. And you start to e things. The things you e can be very complicated indeed.
我有另⼀位病患，她还保有⼀些视⼒。她看到的东西就有点恐怖。有⼀次她说她看到餐厅⾥有⼀个穿
着条纹衬衫的男⼦，男⼦转过⾝来，分裂成六个穿着条纹衬衫的⼈，开始朝她⾛来。然后六个⼈物⼜合并成⼀个，像六⾓⼿风琴折起来⼀样。有⼀次她开车，应该说，是她先⽣在开车，道路分裂成四条，她觉得⾃⼰同时⾛在四条路上。
With another patient of mine, who, also had some vision, the vision she had could be disturbing. On one occasion, she said she saw a man in a striped shirt in a restaurant. And he turned around. And then he divided into six figures in striped shirts, who started walking towards her. And then the six figures came together again, like a concertina. Once, when she was driving, or rather, her husband was driving, the road divided into four and she felt herlf going simultaneously up four roads.
她的幻视也有很动作鲜明的，很多都跟汽车有关。有时候她会看到⼀个青少年坐在汽车引擎盖上，车⼦转弯，他很顽强地坐在那⼉，动作却很优雅。当车⼦停下来时，男孩会突然直线向上冲，离地100呎，然后消失。
kegShe had very mobile hallucinations as well. A lot of them had to do with a car. Sometimes she would e a teenage boy sitting on the hood of the car. He was very tenacious and he moved rather gracefully when the car turned. And then when they came to a stop, the boy would do a sudden vertical takeoff, 100 foot in the air, and then disappear.
我还有⼀位病患，她有另⼀种幻视。这位⼥⼠不是眼睛有问题，⽽是⼤脑处理视觉的部份，枕叶⽪质长了⼀个⼩肿瘤。她最常出现的幻视是卡通。这些卡通是透明的，像⼀层屏幕⼀样，遮盖半个视野。特别的是她会看到科⽶蛙的卡通。（笑声）我不看芝⿇街的。但她特别提出来说：「为什么是科⽶蛙？它对我来说没有任何意义。」我本来在猜想
通。（笑声）我不看芝⿇街的。但她特别提出来说：「为什么是科⽶蛙？它对我来说没有任何意义。」我本来在猜想弗罗伊德决定因素。为什么是科⽶蛙？科⽶蛙对我来说没有任何意义。
Another patient of mine had a different sort of hallucination. This was a woman who didn't have trouble with her eyes, but the visual parts of her brain, a little tumor in the occipital cortex. And, above all, she would e cartoons. The cartoons would be transparent and would cover half the visual field, like a screen. And especially she saw cartoons of Kermit the Frog. (Laughter) Now, I don't watch Sesame Street, but she made a point of saying, "Why Kermit?" she said, "Kermit the Frog means nothing to me. You know, I was wondering about Freudian determinants. Why Kermit? Kermit the Frog means nothing to me."pianist
这些卡通她是不太介意，让她很不安的是脸的幻视不断出现。跟罗莎莉⼀样，这些脸经常是扭曲的，⽛齿很⼤，或是眼睛很⼤，这让她很害怕。这些⼈究竟是怎么了呢？⾝为医⽣，我必须试着解释，并且让病患放⼼。特别是要让他们放⼼，他们并不是发疯了。
She didn't mind the cartoons too much. But what did disturb her was she got very persistent images or hallucinations of faces and as with Rosalie, the faces were often deformed, with very large teeth or very large eyes. And the frightened her. Well, what is going on with the people? As a physician, I have to try and define what's going on, and to reassure people, especially to reassure them that they're not going insane.
⼤脑还有另⼀个部分，在看到卡通时会活跃起来。当我们辨识卡通，画卡通，出现卡通幻视时，这部
份会活跃起来。很有趣地脑中竟然有这样专门的部位。⼤脑还有其他部位经过特化，处理建筑物、景⾊的辨识及幻觉。
voicearch
There is another part of the brain which is especially activated when one es cartoons. It's activated when one recognizes cartoons, when one draws cartoons, and when one hallucinates them. It's very interesting that that should be specific. There are other parts of the brain which are specifically involved with the recognition and hallucination of buildings and landscapes.
1970年左右，研究⼈员发现⼤脑不只有特化的部位，还有特化的细胞。「脸部细胞」是在1970年左右发现的。现在我们知道有上百种不同的细胞，负责⾮常特定的功能。可能不只有「汽车」细胞，可能还有「奥斯顿马汀车」细胞。（笑声）我今天早上看到⼀台奥斯顿马汀车，⾮提⼀下不可。现在那在我脑⼦⾥了。（笑声）
Around 1970, it was found that there were not only parts of the brain, but particular cells. "Face cells" were discovered around 1970. And now we know that there are hundreds of other sorts of cells, which can be very, very specific. So you may not only have "car" cells, you may have "Aston Martin" cells. (Laughter) I saw an Aston Martin this morning. I had to bring it in. And now it's in there somewhere. (Laughter)
英语四级作文题目在这个层级，在颞下⽪质的地⽅只有视觉影像，或者说⽚段。要到更⾼的层级，才有其他感官融⼊进来，跟记忆、情绪链接起来。邦奈特症候群则不会牵涉到较⾼层级，是在颞下视觉⽪质的层级。这⾥有成千上万，甚⾄好⼏百万的影像，或者说⽚段的虚构影像，以神经编码的⽅式储存在特定的细胞或细胞群中。
Now, at this level, in what's called the inferotemporal cortex, there are only visual images, or figments or fragments. It's only at higher levels that the other ns join in and there are connections with memory and emotion. And in the Charles Bonnet syndrome, you don't go to tho higher levels. You're in the levels of inferior visual cortex where you have thousands and tens of thousands and millions of images, or figments, or fragmentary figments, all neurally
