Holly's Secret Garden

Illness as Metaphor, a 1978 work of critical theory by Susan Sontag, examines the cultural and metaphorical representations of two major illnesses: tuberculosis and cancer. The book's key points can be listed as follows:

《疾病如隱喻》是蘇珊·桑塔格（Susan Sontag）於1978年撰寫的批判性理論著作，內容檢視2種主要疾病，肺結核和癌症的文化隱喻。此書的重點列舉如下:

1. Metaphorical portrayal of illnesses: Sontag argues that societies often use metaphors to describe and understand diseases, such as tuberculosis and cancer. These metaphors, though seemingly innocent, can contribute to stigmatization, fear, and misunderstanding surrounding these illnesses.

社會通常使用隱喻来描述和理解疾病，如肺結核和癌症。這些隱喻雖然看似無害，但可能導致疾病受到污名化、引起恐懼和誤解。

2. Tuberculosis as a romanticized disease: Sontag discusses how tuberculosis was once romanticized and associated with artistic and intellectual genius during the 19th and early 20th centuries. This romanticized view obscured the harsh realities of the disease and its impact on patients and society.

在19世紀和20世紀初，肺結核曾被浪漫化，並與天才型藝術家和知識份子聯想在一起。這種浪漫化的觀點掩蓋了這種疾病的嚴酷現實及其對患者和社會的影響。

3. Cancer as a metaphor for evil: Sontag examines the cultural perception of cancer as a metaphor for something evil or morally corrupt. The use of cancer as a metaphor has led to blame and guilt being associated with the illness, causing additional suffering for the patients and their families.

癌症在文化中被視為邪惡或道德敗壞的隱喻。使用癌症作為隱喻導致將責怪和罪惡感與這種疾病聯繫在一起，給患者及其家人帶來了額外的痛苦。

4. Stigmatization of the sick: By exploring the metaphors surrounding illness, Sontag exposes how society tends to stigmatize the sick, blaming them for their conditions or characterizing illnesses as punishment for personal shortcomings.

社會往往會給病人貼上汙名，責怪他們的狀況，或將疾病描繪為對個人缺陷的懲罰。

5. The influence of language: Sontag emphasizes the power of language in shaping public perception and the need to use more accurate, non-metaphorical language when discussing illnesses. She advocates for a more nuanced and compassionate approach to talking about diseases.

Sontag强調語言在塑造公眾認知方面的力量，以及在討論疾病時需要使用更準確、非隱喻性的語言。她主張對疾病談論採取更細緻入微、富有同情心的方式。

6. Myth of the "fight against cancer": Sontag critiques the rhetoric of the "battle" or "war" against cancer, suggesting that this language can create unrealistic expectations and put undue pressure on patients, leading to emotional distress.

Sontag批評了對癌症進行“戰鬥”或“戰爭”之類修辭的做法，她認為這種語言可能產生不切實際的期望，並給患者帶來不必要的壓力，導致情感上的困擾。

7. Social and psychological impact: The book explores the psychological toll of living with a stigmatized illness and how societal attitudes can affect a patient's experience, self-esteem, and sense of identity.

這本書探討了生活在受汙名化疾病中的心理負擔，以及社會態度如何影響患者的經歷、自尊心和認同感。

Overall, Illness as Metaphor urges readers to challenge and rethink the language and cultural attitudes surrounding illness, promoting a more empathetic and understanding approach towards those affected by diseases.

總體而言，《疾病作為隱喻》敦促讀者挑戰和重新思考圍繞疾病的語言和文化態度，推動對受疾病影響的人採取更具同理和理解的態度。

這部45年前的作品，至今依然引起共鳴。癌症時鐘加快了數倍，它的文化隱喻還是沒變! 報導名人罹患癌症，還是這些字眼: “病魔”、“驚”傳“不幸” 罹癌、“抗”癌 “鬥士"等。這些字傳達的依舊是負面的、驚恐的情緒。癌症依舊是頑強的敵人，需要病患去對抗、搏鬥。它的汙名化依舊存在。會罹癌的原因不斷被檢討，如個性壓抑、飲食不健康、作息不正常、基因缺陷等。如果生病的具體因果關係無法論斷，就用宗教的前世惡業感今世果報來解釋。看來，對於疾病的驚懼佈畏仍根深蒂固，牢不可破!

Excerpts from the Book:

Sontag, Susan. Illness as Metaphor and AIDS and Its Metaphors. Doubleday, 1978. 

Contact with someone afflicted with a disease regarded as a mysterious malevolency inevitably feels like a trespass; worse, like the violation of a taboo ( 6).

與患上被視為神秘邪惡的疾病的人接觸，不可避免地感覺像是越界；更糟糕的是，像是觸犯了禁忌

Cancer patients are lied to, not just because the disease is (or is thought to be) a death sentence, but because it is felt to be obscene---in the original meaning of that word: ill-omened, abominable, repugnant to the senses (9). 

癌症患者被隱瞞病情，不僅是因為這種疾病被認為是一個死刑判決，而且還因為它被感覺是淫穢的---按照該詞的原始含義：不祥的、可憎的，令人厭惡的。

The dying tubercular is pictured as made more beautiful and more soulful; the person dying of cancer is portrayed as robbed of all capacities of self-transcendence, humiliated by fear and agony (17).

垂死的肺結核患者被描繪得更美麗、更有靈魂；而癌症患者則被描述成喪失了超越自我的所有能力，被恐懼和痛苦所羞辱。

While TB takes on qualities assigned to the lungs, which are part of the upper, spiritualized body, cancer is notorious for attacking parts of the body (colon, bladder, rectum, breast, crevix, prostate, testicles) that are embarrassing to acknowledge (17).

結核病有肺部專屬的特質，位於身體上方，具精神意義；而癌症因攻擊一些讓人尷尬承認的身體部位（如結腸、膀胱、直腸、乳房、子宮頸、前列腺、睾丸）而惡名昭著。

A disease of the lungs is, metaphorically, a disease of the soul. Cancer, as a disease that can strike anywhere, is a disease of the body. (18)

肺部疾病在隱喻上是靈魂的疾病。而癌症作為一種可以在身體的任何部位發作的疾病，是身體的疾病。

The Romantics moralized death in a new way with the TB death, which dissolved the gross body, etherealized the personality, expanded consciousness. It was equally possible, through fantasies about TB, to aestheticize death. . . . Nobody conceives of cancer the way TB was thought of---as a decorative, often lyrical death (19-20).

浪漫主義者以一種新的方式將結核病的死亡道德化，它使粗俗的身體溶解，個性飄渺，意識擴展。通過對結核病的幻想，同樣有可能美化死亡......沒有人將癌症看作像結核病那樣---一種裝飾性的、經常是抒情的死亡。

TB was thought to come from too much passion, afflicting the reckless and sensual, today many people believe that cancer is a disease of insufficient passion, afflicting those who are sexually repressed, inhibited, unspontaneous, incapable of expressing anger (21).

人們認為結核病來自過多的激情，折磨那些魯莽而感性的人。而今天，許多人相信癌症是由激情不足引起的疾病，折磨那些性壓抑、抑制、缺乏自發性、無法表達憤怒的人。

According to the mythology of cancer, it is generally a steady repression of feeling that causes the disease. In the earlier, more optimistic form of this fantasy, the repressed feelings were sexual; now, in a notable shift, the repression of violent feelings is imagined to cause cancer (22).     

根據癌症的神話，通常是持續的情感壓抑導致了這種疾病。在早期更為樂觀的想像中，被壓抑的情感是性欲；而現在有顯著的轉變，導致癌症被想像成是對強烈情感的壓抑。

the typical accounts of TB in the nineteenth century all feature resignation as the cause of the disease (24). . . . The suffers may be represented as passionate but are more characteristically, deficient in vitality, in life force.(25)

19世紀關於結核病的典型描述，都將無可奈何地放棄認為是該疾病的原因。這些患者可能被描繪成充滿激情，但更顯著的是，他們缺乏活力，缺乏生命力。

For snobs and parvenus and social climbers, TB was one index of being genteel, delicate, sensitive. . . . Both clothes (the outer garment of the body) and illness (a kind of interior decor of the body) became tropes for new attitudes toward the self. (28)

對於勢利小人、暴發戶和想出頭天的人來說，結核病是彰顯優雅、精緻、敏感的一種指標......服裝（身體的外在裝飾）和疾病（一種身體內在裝飾）都成為了表達對自我新態度的隱喻。

the romanticizing of TB is the first widespread example of that distinctively modern activity, promoting the self as an image. The tubercular look had to be considered attractive once it came to be considered a mark of distinction, of breeding. (29)

將結核病浪漫化是第一個廣為流傳的現代化案例，這是一種將自我化成一種形象，加以宣揚的行為。患有結核病的外貌一旦被視為優雅、高貴的標誌時，就被認為是吸引人的。

The romantic treatment of death asserts that people were made singular, made more interesting, by their illness. . . . Sadness made one “interesting.” It was a mark of refinement, of sensibility, to be sad. (31)  

死亡的浪漫化表達了這樣一種觀點：人們因他們的疾病而變得獨特，變得更有趣。悲傷使一個人變得“有趣”。它是優雅、敏感的標誌，感到悲傷被視為一種優雅的表現。

The TB sufferer was a dropout, a wanderer in endless search of the healthy place. . . . The Romantics invented invalidism as a pretext for leisure, and for dismissing bourgeois obligations in order to live only for one’s art. (33-34)

結核病患者是一個逃離者，在無休止地尋找健康的地方漂泊......浪漫主義者將病弱作為藉口來尋求休閒，只為藝術而生，摒棄了資產階級的責任。

In contrastto the modern bogey of the cancer-prone character---someone unemotional, inhibited, repressed---the TB-prone character that haunted imaginations in the nineteenth century was an amalgam of two different fantasies: someone both passionate and repressed. (p.39)

現代對於易罹癌的人的恐懼是認為他們冷漠、受抑制、壓抑。與之形成對比的是，在19世紀引發想像的易患結核病的人是兩種不同幻想的結合體：既充滿激情又受到壓抑的人。

The view of cancer as a disease of the failure of expressiveness condemns the cancer patient; it evinces pity but also conveys contempt (48).

視癌症為表達能力不足的疾病，是貶斥癌症患者的想法。這表現出同情，但也傳達了蔑視之情。

The tubercular could be an outlaw or a misfit; the cancer personality is regarded more simply, and with condescension, as one of life’s losers. (49)

結核病患者可能是一名逃犯或局外人；而癌症患者的個性被歧視，被簡化成生活中的失敗者。

Investigations are cited---most articles refer to the same ones---in which out of, say, several hundred cancer patients, two-thirds or three-fifths report being depressed or unsatisfied with their lives, and having suffered from the loss (through death or rejection or separation) of a parent, lover, spouse, or close friend. But it seems likely that of several hundred people who do not have cancer, most would also report depressing emotions and past traumas: this is called the human condition.

根據調查研究---大多數文章都引用了同樣的研究---比如說，在幾百名癌症患者中，有三分之二或五分之三的人說他們感到沮喪或對生活不滿意，並且曾經經歷過失去（透過死亡、拒絕或分離）父母、戀人、配偶或親近的朋友。但很可能在幾百名沒有癌症的人中，大多數人也會有沮喪的情緒和過去的創傷：這就是人類的狀況。

Punitive notions of disease have a long history, and such notions are particularly active with cancer. There is the “fight” or “crusade” against cancer; cancer is the “killer” disease; people who have cancer are “cancer victims. (57)

視疾病為懲罰的觀念有著悠久的歷史，這種觀念在癌症方面尤其顯著。與癌症進行所謂的“戰鬥”或“長途征戰”；癌症被稱為“殺手”疾病；患有癌症的人被稱為“癌症受害者。

For more than a century and a half, tuberculosis provided a metaphoric equivalent for delicacy, sensitivity, sadness, powerlessness; while whatever seemed ruthless, implacable, predatory, could be analogized to cancer. . . . TB was an ambivalent metaphor, both a scourge and an emblem of refinement. Cancer was never viewed other than as a scourge; it was, metaphorically, the barbarian within. (61)

超過一個半世紀以來，結核病成為了精緻、敏感、悲傷、無助的隱喻；而任何看似無情、不可動搖、掠奪性的東西都可以類比為癌症......結核病是一個矛盾的隱喻，既是一種災禍，又是優雅的象徵。而癌症從未被視為除了災禍之外的其他東西；在隱喻上，它是內在的野蠻力量。

Modern totalitarian movements . . . have been peculiarly . . . inclined to use disease imagery. The Nazis declared that someone of mixed “racial” origin was like a syphilitic. European Jewry was repeatedly analogized to syphilis, and to a cancer that must be excised. (82)

現代的極權主義運動……在使用疾病隱喻方面有其獨特的傾向。納粹宣稱有混合“種族”的人就像患有梅毒。歐洲的猶太人曾多次被類比為梅毒，是必須切除的癌症。

To describe a phenomenon as a cancer is an incitement to violence. The use of cancer in political discourse encourages fatalism and justifies "severe” measure. (83)

將某種現象描述為癌症是在煽動暴力。在政治話語中提到癌症，是鼓勵宿命論，並為採取“嚴厲”手段提供了理由。

Conclusion:

Our views about cancer, and the metaphors we have imposed on it, are so much a vehicle for the large insufficiencies of this culture: for our shallow attitude toward death, for aour anxieties about feeling, for our reckless improvident responses to our real “problems of growth,” for our inability to construct an advanced industrial society that properly regulates consumption, and for our justified fears of the increasingly violent course of history. (87)  

我們對癌症的看法，以及我們賦予它的隱喻，在很大程度上是文化深刻不足的載體：體現了我們對死亡的膚淺態度，對情感的焦慮，對我們真正的“增長問題”的魯莽應對，對無法建立適當調控消費的先進工業社會的無能，以及對歷史日益暴力化走勢的合理擔憂。