;    4 篇章的对等

       词汇对等和句子对等的最终目标是语篇对等。理解篇章对等，首先要理解语篇体裁这一概念。Swales给语篇体裁下了定义：语篇体裁是含有某类共同交际目的的交际事件。这些交际目的被源语篇使用者所识别，构成该语篇的基本要素。除共同的交际目的外，同一语篇体裁的文章在结构、风格、内容和读者群上都表现出相似性。_6]具体的语篇体裁是通过两种方式来体现：“纲要式结构”(schematic structure)和“体现样式”(realizational patterns)。[7]纲要式结构是指有阶段的、有步骤的结构，而语篇体裁的体现样式则是由特定的语言结构充当。就医学文献而言，其种类繁多，包括论文，病例报道，医学综述，药品说明书等等，这些文章目的不同，读者各异，文章结构和语体风格也大相径庭，因此译者必须同时作为源语语篇的接受者与译语语篇的产出者，对两种语篇进行比较，以求得等值。下面我们通过对病历记录这一特殊医学语篇体裁的翻译对医学文章的篇章对等进行阐述。病历原文为中文。

       入院记录

       患者，女，30岁，已婚。因发热，咳嗽7天，于1996年8月3日入院。

       7天前开始发热，、咳嗽、吐黏液痰，至今未治疗。近3天，持续高热。咳嗽加剧。吐铁锈色痰，胸痛，随呼吸加剧。

       患病期，乏力，食欲差，大、小便正常。

       既往体健，很少就医。

       家中无人患结核病，患者是否有与结核病人密切交往史不详。

       体检：体温39，脉搏107次／min，呼吸26次／min，血压1 10／70mmHg

       发育正常，营养不良。急性病容，神志清楚。无发绀，皮肤无疹子及紫癜，无浅淋巴结肿大。头颅正常，巩膜无黄染。颈活动自如，甲状腺未肿大。气管无偏移，颈静脉不充盈。胸廓对称。右上胸语颤有增强，可听到许多中小湿性咯音。心跳正常，无杂音。腹平软，无触痛。肝脾未及，肠鸣音正常。脊柱和四肢无异常。双侧膝反射活跃。无病理反射。

       血常规：红细胞450万／胁3，血红蛋白14．5g％，白细胞21000／胁3，中性，淋巴19％，嗜酸1％。

       血小板计数：15万／l眦n3

       胸透：右上肺有大片状阴影。

       译文1

       Admission Note

       The patient is a 30-year-old married woman．Because she had fever and cough for 7 days，she was admitted to the hospital on August 3，1996．

       Seven days ago she began to have a fever，cough and spit mucous sputum，but she bad not received any medical treatment up to know．In the past three days，she bad a persistent fever，and the cough became serious．She spit rusty sputum．She felt chest pain and it intensified with respirations．

       During her illness，she was lack of strength．Her appetite was poor．Her urine and stools were norma1．

       She was healthy in the past and seldom went to doctor．

       Nobody in her family had ever got tuberculosis and she did not know of any intimate contact with patients with this disease either．

       Physical Examination：the patient was normally developed and poorly nourished．She looked acutely ill but her mind was still clear．There was no cyanosis，no eruption，or purpura

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