/.+ PN=JOLKNPA U I =@ Q N=?
Eï J
Bdbpm\ /.*.+ I db m\^dÄ i _ ` g\n ^|gpg\n b ` mh di \g`n k mdh j m_ d\ g` n _`n_` `g n\^j qdo` gdi j \ g\n ^m`no\n bji\_\g`n
H\n ^~gpg\n b`mhdi\g`n kmdhjm_d\g`n)
_`mdq\_\n _`g n\^j qdo`gdij) `iom\i \g
dio`nodij kjno`mdjm+ Ag m`^`kojm ^*fdo t `g
a\^ojm _` g\n ^|gpg\n h\_m` %j gdb\i_j
_` ^*fdo& ^jiomjg\i g\ hdbm\^dÇi ^`gpg\m t
o\h]d~i di_p^`i g\ kmjgda`m\^dÇi _` g\n
^~gpg\n b`mhdi\g`n kmdhjm_d\g`n lp` hdbm\i+
H\ hdbm\^dÇi _` g\n ^~gpg\n b`mhdi\g`n
kmdhjm_d\g`n _`n_` _`g n\^j qdo`gdij c\no\
g\n ^m`no\n bji\_\g`n dhkgd^\ om`n k\njn7
M Pm\ingj^\^dÄi _`n_` `g n\^j qdo`gdij
c\no\ `g dio`nodij kjno`mdjm+
M Idbm\^dÄi _`n_` `g dio`nodij kjno`mdjm
\ g\n ^m`no\n bji\_\g`n \om\q`n\i_j `g
h`n`io`mdj+
M ?jgjidu\^dÄi `i g\ ^m`no\ bji\_\g `
dio`m\^^dÇi ^ji g\n ^~gpg\n _` O`mojgd k\m\
ajmh\m ^jm_ji`n o`nod^pg\m`n+
H\n ^|gpg\n _` H`t_db a`o\g`n %_`mdq\_\n
_` g\n ^~gpg\n h`nji~amd^\n& kmj_p^`i
o`nojno`mji\ k\m\ `nodhpg\m g\ _da`*
m`i^d\^dÇi _`g ^ji_p^oj _` Sjgaa)
H\n ^|gpg\n _`
%_`mdq\_\n _` g\n ^m`no\n bji\_\g`n&
kmj_p^`i g\ cjmhji\ \iodhÇgg`md\i\
%=ID& lp` di_p^` g\ m`bm`ndÇi _` gjn
^ji_p^ojn _` IÑgg`m+
& /-./+ Bhoarean Bol]Å]) P+I+ Oaoanr]`ko pk`ko hko `ana_dko
@AH AOLANI =PK VK E@A
@AO=NNKHHK @A H=O ?ïJ=@=O
Bh _]lÄpqhk /. _kieajv] _kj qj] nareoeÇj `a hko _kj_alpko bqj`]iajp]hao ok^na ah
`ao]nnkhhk ckj]`]h u `a hko _kj`q_pko abanajpao %at_napknao&+ Bopk jko laniepen}
_kjk_an h] deopkhkcÄ]) h] bqj_eÇj u h] eilknp]j_e] _hÄje_] `a h] rÄ] mqa oecqaj hko
c]iapko i]o_qhejko u baiajejko d]op] hhac]n ] h] ba_qj`]_eÇj+
Rj ]ola_pk eilknp]jpa mqa oa `a^a na_kn`]n ao mqa h]o _~hqh]o lna_qnokn]o `a
]i^ko pelko `a c]iapko peajaj qj knecaj atpn]ai^nekj]nek+ I]o _~hqh]o caniej]hao
lneikn`e]hao %@DM& ]l]na_aj aj ah aj`k`anik `a h] l]na` `ah o]_k repahejk lkn
rav lneian] aj ah bapk `a 1 oai]j]o %bec+ / . * . &+
?~gpg\n h`nji~amd^\n ^ji km`^pmnjm`n _`
^~gpg\n _` H`t_db
Akdo`gdj ^`gÇhd^j lp` m`qdno` g\ ^m`no\ bji\_\g
M ? j gj i du \ ^ dÄ i Z Z Z Z 'Z t
?m`no\ bji\_\g ?jmo`u\
M Idbm\^dÄi
I|_pg\
L Pm\ingj^\^dÄi
Eio`nodij kjno`mdjm H\ ^jmo`u\
_` g\ bÇi\_\
di_da`m`i^d\_\ n`
^jiqd`mo` `i jq\mdj+
B\^ojm _` ^|gpg\n h\_m` %j gdb\i_j H\ h|_pg\ _` g\ bÇi\_\ di_da`m`i*
_` ^*fdo&) pi gdb\i_j om\inh`h]m\i\ ^d\_\ n` ^jiqd`mo` `i `g o`noÄ^pgj
k\m\ `g m`^`kojm ^*fdo8 `g m`^`kojm t `g ]\ej g\ diagp`i^d\ _` pi\ kmjo`Äi\
gdb\i_j n` `skm`n\i `i g\n ^~gpg\n _` bmpkj _` \go\ hjqdgd_\_ %DIC&
1ë b`mhdi\g`n kmdhjm_d\g`n+ ip^g`\m) ^j_dad^\_\ kjm pi\ m`bdÄi
?~gpg\ b`mhdi\g _`o`mhdi\io` _`g n`sj _`g b`i
kmdhjm_d\g N`^`kojm ^*fdo) pi\ odmjndi\ ^di\n\ _`g ^mjhjnjh\ U %Oaet&+
Od ij n` kmj_p^` g\ `skm`ndÇi
_` ONU j `no} \go`m\_\) jom\n
^\n^\_\n _` m`bpg\^dÇi ^ji_p^`i \g
_`n\mmjggj _`g jq\mdj t _` g\n
^\m\^o`mÄnod^\n a`h`idi\n)
O`mojgd a`o\g`n Hjn kmjb`idojm`n _` g\n `nk`mh\ojbj*
id\n) _`mdq\_jn _` g\n ^~gpg\n b`mhdi\*
H\n ^|gpg\n hdjd_`n k`mgop]p*
g`n kmdhjm_d\g`n) lp`_\i di^jmkjm\_jn \
g\m`n t gjn q\njn n\ibp}i`jn
gjn ^jm_ji`n o`nod^pg\m`n mj_`\_jn kjm g\n
n` _`n\mmjgg\i \ k\modm _` g\n
^~gpg\n _` O`mojgd _`mdq\_\n _`g `kdo`gdj
^~gpg\n h`nji~amd^\n+
^`gÇhd^j+
3.4
booksmedicos.org
 Bdbpm\ /.*/+ U9B:0179éBMf»: PF 6B -»:BPB f:Pf1F9F:MfBPB F: F6 qF0qJMZ67

N`bdÄi _`o`mhdi\io` _`g n`sj `i U %ONU&

E
?mjhjnjh\ U & Qy& $& ******** s e7 ?mjhjnjh\ T

?jmo`u\ I|_pg\
%jq\mdj& %o`no}^pgj& Lmjo`di\ ip^g`\m ^ji _jhdidj _`
N`^`kojm _` \i_mÄb`ijn Z 2 Z
bmpkj _` \go\ hjqdgd_\_ %DIC&

?ji_p^oj _` Sjgaa `h]mdji\mdj

?jm_ji`n o`nod^pg\m`n # P`nojno`mji\ R`n}^pg\ n`hdi\g

?ji_p^oj _`a`m`io`
Akd_}_}hj
?|gpg\ _` 2\*m`_p^o\n\ í
Ag b`i LKR n` `skm`n\ _` ajmh\ H`t_db
om\indojmd\ `i d\n ^~gpg\n _` O`mojdd @dcd_mjo`nojno`mji\ LmÄno\o\
k\m\ did^d\m pi\ ^\n^\_\ lp` ^pghdi\
Qm`om\
`i g\ ajmh\^dÇi _`g o`noÄ^pgj \ k\modm
L`i` t `n^mjoj
_` g\ bÇi\_\ di_da`m`i^d\_\+

?|gpg\ _`
O`dgjgd
?ji_p^oj _` Sjgaa `i _`n\mmjggj ?ji_p^oj _` gdÄÑgg`m \omÇad^j

b e* H\ =ID diodd]` `g _`n\mmjggj _` gjn

$ _`mdq\_jn _`g ^ji_p^oj _` IÑgg`m
Djmhji\ \iodhÑgg`md\i\ %=E%,ED& `h]mdji\mdj %jqd_p^oj) Éo`mj t ^p`ggj
po`mdij&+

Bjpna h]o 1 u 3 oai]j]o) ajpna .- u .-- _~hqh]o caniej]hao lneikn`e]hao iecn]j

ia`e]jpa ikreieajpko ]ia^ke`ao `ao`a ah o]_k repahejk ]h pq^k ejpaopej]h u `ao`a aopa
] hko h]`ko `ana_dk a evmqean`k `a h] l]na` `kno]h `ah _qanlk ]pn]rao]j`k ah iaoajpanek+
I] iecn]_eÇj u h] lnkheban]_eÇj `a h]o _~hqh]o caniej]hao lneikn`e]hao `alaj`aj
`a h] ejpan]__eÇj `ah na_alpkn _*gep) qj] penkoej] _ej]o]) _kj oq _knnaolkj`eajpa
hec]j`k aj h] iai^n]j] _ahqh]n) ah b]_pkn `a _~hqh]o i]`na %k hec]j`k `a _*gep&+
Q]jpk ah na_alpkn _*gep _kik ah b]_pkn `a _~hqh]o i]`na okj lnk`q_e`ko lkn h]o _~hqh]o
caniej]hao lneikn`e]hao ] hk h]nck `a oq rÄ] `a iecn]_eÇj+
I] ]qoaj_e] `a na_alpkn _*gep k `ah b]_pkn `a _~hqh]o i]`na `apaniej] qj] `abe_eajú
_e] `a _~hqh]o caniej]hao lneikn`e]hao aj h]o cÇj]`]o+ I] dai]pklkuaoeo u ah `ao]nnkhhk
`a hko iah]jk_epko u i]opk_epko `alaj`aj `ah na_alpkn _*gep u `a oq hec]j`k+
Bj h] l]na` `kno]h `ah _qanlk ateopaj ajpna /+2-- u 2+--- _~hqh]o caniej]hao
lneikn`e]hao ]h^anc]`]o aj ah iao~jmqei] ] h] ]hpqn] `a h] `~_ei] r~npa^n] pkn}_e_])
h]o _q]hao ej`q_aj h] lnkheban]_eÇj `a h]o _~hqh]o `ah iaokjabnko u `ah alepaRk `a
naraopeieajpk _ahÇie_k l]n] knecej]n qj l]n `a _naop]o ckj]`]hao+ Aajpnk `ah iao~jú
mqei] `a aop]o _naop]o ckj]`]hao _na_aj _kn`kjao `a _~hqh]o alepahe]hao _ahÇie_]o l]n]
knecej]n h] _knpav] atpanj] u h] i~`qh] ejpanj] `a h] cÇj]`] ej`ebanajpa+

Ag a\^ojm _`o`mh di\io` _`g o`no}^pgj ^jiomjg\ `g _`n\mmjggj _`g o`no}^pgj

E]op] h] o~lpei] oai]j] `ah `ao]nnkhhk bap]h oa aj_qajpn] qj] cÇj]`] _kiÉj l]n] ]i^ko
oatko u aop] b]oa `ah `ao]nnkhhk ckj]`]h oa hh]i] èej`ebanaj_e]`]ê+ Mkopanekniajpa) aj h]
iqfan) h] _knpav] oa _kjreanpa aj ah kr]nek p h] i~`qh] ejrkhq_ekj]) ieajpn]o mqa aj
ah r]nÇj oq_a`a ]h nar~o7 h] _knpav] ejrkhq_ekj] u h] i~`qh] `] hqc]n ]h paopÄ_qhk+
Bh `ao]nnkhhk `ah paopÄ_qhk oa _kjpnkh] lkn qj] lnkpaÄj] `ah `kiejek `ah cnqlk `a
]hp] ikrehe`]` jq_ha]n %EJD& _k`ebe_]`] lkn ah caj `a h] naceÇj `apaniej]jpa `ah
oatk `ah _nkikoki] V $LCkO%)
Pkt6 %l]n] ah caj 6 mqa _kjpeaja h] oa_qaj_e] POV& ao qj lkoe^ha _]j`e`]pk _kik
caj `e]j] `ena_pk `a POV I] l~n`e`] `a bqj_eÇj `a aopa caj ao knecaj `a h] `eocajaoe]

3.5 E Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\

booksmedicos.org

?p\_mj /.*= v @ `n\mmj ggj _` gjn b ` ido\g`n
dio`mijn
à ?p\i_j g\ =ID kmj_p^d_\ kjm g\n ^|gpg\n _` O`mojgd
ij `no{ km`n`io`) djn ^ji_p^ojn _` IÑdg`m n` ^jiqd`mo`i
`i g\n omjhk\n _` B\djkdj %jqd_p^ojn&) `g Éo`mj) `d ^p`ggj
po`mdij t `d o`m^dj npk`mdjm _` d\ q\bdi\+
à Ai km`n`i^d\ _` g\ o`nojno`mji\ `g\]jm\_\ kjm g\n
^|gpg\n _` H`t_db) djn ^ji_p^ojn _` Sjgoa n` ^jiqd`mo`i
`i `d `kd_Ä_dhj) `d ^ji_p^oj _`a`m`io`) g\n q`nÄ^pg\n
n`hdi\g`n t gjn ^ji_p^ojn `t\^pg\_jm`n+
à Ai km`n`i^d\ _` 2\*m`_p^o\n\) g\ o`nojno`mji\ n`
^jiqd`mo` `i _gcd_mjo`nojno`mji\ %@DP&+ H\ @dDP Ei_p^`
d\ ^jiq`mndÇi _`g op]~m^pgj b`ido\d) _`d kdd`bp` b`ido\d) _`
d\ oph`a\^^dÇi b`ido\d) t _`g n`ij pmjb`ido\g `i `d k`i`)
`g `n^mjoj t d\ kmÇno\o\+
à Ai \pn`i^d\ _` @DP) `g op]~m^pgj b`ido\d) `g kdd`bp`
b`ido\g) g\ oph`a\^^dÇi b`ido\d t `g n`ij pmjb`ido\g n`
^jiqd`mo`i `i gjn g\]djn h\tjm`n t h`ijm`n) `d ^gdojmdn t
djn _jn o`m^djn dia`mdjm`n _` g\ q\bdi\+
ckj]`]h UV) aj h] mqa hko l]_eajpao lnaoajp]j qj]o aopnq_pqn]o ckj]`]hao lk_k
`ao]nnkhh]`]o %_ejpehh]o ckj]`]hao& u ]qoaj_e] `a renehev]_eÇj %lanoeopaj_e] `a aopnq_ú
pqn]o `a knecaj iÑhhane]jk&+
Bpi^dÄi _` g\ cjmh ji\ \iodh Çgg`md\i\ t g\ o`nojno`mji\
`i `g _`n\mmjggj _` gjn b`ido\g`n dio`mijn h\n^pgdijn t a`h `idijn
Bh paopÄ_qhk bap]h aop} bkni]`k lkn _kn`kjao paope_qh]nao _kja_p]`ko _kj h] na` paopeú
_qh]n ia`e]jpa pÉ^qhko na_pko+ Iko _kn`kjao aop}j _kjopepqe`ko lkn h]o _~hqh]o `a
Panpkhe) `aner]`]o `ah alepahek _ahÇie_k) u lkn lnaaolani]pkckje]o %hh]i]`]o p]i^e~j
ckjk_epko&) `aner]`]o `a h]o _~hqh]o caniej]hao lneikn`e]hao+ Pa e`ajpebe_]j _~hqh]o `a
Iau`ec) `aner]`]o `ah iao~jmqei] iaokj~bne_k) ajpna hko _kn`kjao paope_qh]nao+
I]o _~hqh]o `a Panpkhe bap]hao oa_nap]j h] dknikj] ]jpei Ñhhane]j] %>JE&) mqa
eile`a h] _kjranoeÇj `a hko _kj`q_pko `a J Ñhhan %hh]i]`ko p]i^e~j l]n]iaokj~*
bne_ko& aj ah lneikn`ek qpankr]cej]h %bec+ /.*/&+ @q]j`k jk ateopa >JE) hko _kjú
`q_pko iÑhhane]jko lanoeopen}j u `]n}j knecaj ] hko cajep]hao ejpanjko baiajejko+
> h]o 5 oai]j]o `a caop]_eÇj) h]o _~hqh]o `a Iau`ec bap]hao lnk`q_aj paopkopankj])
mqa oa nacqh] lkn h] ckj]`kpnklej] _kneÇje_] dqi]j] %d@D&) `]`k mqa h] delÇbeoeo
bap]h jk oa_nap] h] dknikj] hqpaejev]jpa %IE&+
Bh atpnaik _ab}d_k `a hko _kj`q_pko `a Tkhbb %hh]i]`ko p]i^e~j _kj`q_pko
iaokj~bne_ko& bkni] ah ale`Ä`eik) ah _kj`q_pk `abanajpa u ah _kj`q_pk au]_qh]`kn+
Rj `eranpÄ_qhk `ah _kj`q_pk `abanajpa bkni] h]o raoÄ_qh]o oaiej]hao+
I] lnÇop]p] u h] qnapn] oa `ao]nnkhh]j ] l]npen `ah oajk qnkcajep]h+ Bh knecaj
lnkop}pe_k ao `k^ha7 ah alepahek ch]j`qh]n oa bkni] _kik ar]cej]_ekjao `ah aj`k*
`anik qnapn]h lnkop}pe_k) ieajpn]o mqa ah aopnki] u ah iÉo_qhk dok lnk_a`aj `ah
iaok`anik _en_qj`]jpa+
Bj ]qoaj_e] `a ]j`nÇcajko) ah _kj`q_pk `a Tkhbb ejrkhq_ekj] u h] lnÇop]p] jk
oa `ao]nnkhh]+ @q]j`k qj bapk `a oatk baiajejk peaja ahar]`]o _kj_ajpn]_ekjao `a
]j`nÇcajko) lqa`aj lanoeopen hko _kj`q_pko `a Tkhbb u J Ñhhan %r+ _q]`nk /.*>&+
@`n^`inj o`nod^pg\m
Bh cq^anj}_qhk oa bkni] aj ah lkhk ejbanekn `ah paopÄ_qhk) ]pn]reao] `a bkni] k^he_q] h]
l]na` ]^`kiej]h qja ah paopÄ_qhk ] h] vkj] `a pqiab]__eÇj ao_nkp]h+ Bj h] oai]j] /5) ah
paopÄ_qhk oa ejpnk`q_a aj h] lnkbqj`e`]` `ah ]jehhk ejcqej]h+ Bh cq^anj}_qhk ]qiajp] `a
p]i]Åk u ah paopÄ_qhk `ao_eaj`a d]_e] ah ao_nkpk+ Pa lqa`aj aj_kjpn]n i}o `ap]hhao ok^na
h] _nelpknmqe`e] %k b]hp] `a `ao_ajok paope_qh]n& aj ah _]lÄpqhk /-) èBolani]pkcaje]ê+
Eh kjmo\i^d\ ^g}id^\7 n}i_mjh ` _` Ggdi`a`go`m
Bh oÄj`nkia `a Hhejabahpan oa lnk`q_a aj r]nkjao _kj qj _nkikoki] U ]`e_ekj]h
%14)UUV&+ Iko ej`ere`qko _kj aopa oÄj`nkia7 .& okj r]nkjao `ao`a qj] lanola_per]
bajkpÄle_] %peajaj qj _nkikoki] V&8 /& lnaoajp]j paopÄ_qhko lamqaÅko u peajaj lk_]o
_~hqh]o aolani]pkc~je_]o8 0& peajaj qj]o _kj_ajpn]_ekjao ]hp]o `a dknikj] aopeiqú
h]`kn] `a hko bkhÄ_qhko %CPE& lknmqa h] bqj_eÇj `a h]o _~hqh]o `a Panpkhe ao ]jÇi]h]
%jk lqa`a ah]^kn]n ejde^ej]&) u 1& iqaopn]j ^]f]o _kj_ajpn]_ekjao `a paopkopankj])
lank ]hp]o `a aopn]`ekh+
Bh at_aok `a aopn]`ekh lqa`a k_]oekj]n qj] baiejev]_eÇj bajkpÄle_]) mqa ej_hqua
ceja_ki]ope]+
Eh kjmo\i^d\ ^g}id^\7 n}i_mjh ` _` din`ind]dgd_\_ \i_mjb|id^\
%a`h didu\^dÄi o`nod^pg\m&
Bh oÄj`nkia `a ejoajoe^ed`]` ]j`nkc~je_] %PF>& oa `a^a ] qj `aba_pk _kilhapk k
l]n_e]h `ah caj mqa _kjpnkh] h] atlnaoeÇj `ah na_alpkn `a ]j`nÇcajko) hk_]hev]`k aj
ah _nkikoki] U+
>qjmqa ah _]nekpelk ao 13)UV) h] `abe_eaj_e] `a h] ]_pere`]` `a hko ]j`nÇcajko oa
pn]`q_a aj qj] b]hp] `a `ao]nnkhhk `ah _kj`q_pk `a Tkhbb u h] ejrkhq_eÇj `ah _kjú
`q_pk `a JÑhhan) `]`k mqa ateopaj paopÄ_qhko u) aj _kjoa_qaj_e]) h] >JE knecej]`]
aj h]o _~hqh]o `a Panpkhe+
Kk ateopaj cajep]hao ejpanjko bqj_ekj]hao aj hko l]_eajpao _kj PF>7 hko paopÄ_qhko
lani]ja_aj `ajpnk `ah ]^`kiaj %na_qan`a mqa hko ]j`nÇcajko aopeiqh]j ah `aoú
_ajok paope_qh]n&+
Iko cajep]hao atpanjko oan}j `a pelk baiajejk+ Iko l]_eajpao _kj qj PF> _kiú
lhapk lnaoajp]j h]^eko) _hepkneo u qj] r]cej] _knp] %aop]o aopnq_pqn]o jk peajaj qj
/ . + PN = JOLK N PA U I = @ Q N = ? Eï J @AH AOLANERE=PKVKE@A E 3.6
booksmedicos.org
 Bdbpm\ /.*0+ U9B:0v79qF PF6 F0vF9éBq7x7fPF PF0PF F6 qF0qJMZ67 3B0qB 6B 9FP qF0qfMZ6B9 B q9B(V0 PF 670 q=,Z670 9FMq70

H\n ^~gpg\n _` O`mojgd ^dgdi_md^\n

h\m^\i g\ om\ind^dÇi `iom` `g
`kdo`gdj n`hdiÄa`mj t `g oÉ]pgj
m`^oj+

H\n pidji`n c`mh~od^\n ]\n\g`n

`iom` g\n ^|gpg\n _` O`mojgd
^dgdi_md^\n n` ^jiqd`mo`i `i KI
pidji`n c`mh~od^\n \kd^\g`n
`iom` g\n ^|gpg\n _` O`mojgd
^Å]d^\n `i `g oÉ]pgj m`^oj t g\
m`_ o`nod^pg\m+ Ag _jhdidj \kd^\g
_` g\n ^~gpg\n _` O`mojgd
^É]d^\n hp`nom\ hd^mjq`ggjnd*
_\_`n t \gbÉi ^dgdj kmdh\mdj
j^\ndji\g+

R\nj n\ibpÄi`j

j$

Ai g\ kmjsdhd_\_ _` gjn q\njn gdia}od*

^jn t n\ibpÄi`jn n` `i^p`iom\i
\bm`b\_jn _` ^|gpg\n _` H`t_db)
oj_jn \kjt\_jn `i o`ed_j ^jiepiodqj
g\sj+

knecaj iÑhhane]jk&) lank jk peajaj rahhk ]teh]n je lÉ^e_k %ah `ao]nnkhhk `ah rahhk
oatq]h `alaj`a `a hko ]j`nÇcajko&+
Bj h] lq^anp]` ]qiajp] h] lnk`q__eÇj `a ]j`nÇcajko u aopn]`ekh %aop] Éhpei]
oqop]j_e]) lkn ]nki]pev]_eÇj laneb~ne_] `a hko ]j`nÇcajko&+ Iko ]j`nÇcajko jk
lqa`aj ejde^en h] oa_na_eÇj `a IE %lknmqa ah `aba_pk `ah na_alpkn `a ]j`nÇcajko
eile`a h] napnk]heiajp]_eÇj lkn IE& u h]o _kj_ajpn]_ekjao lh]oi}pe_]o `a ]j`nÇcaú
jko oecqaj oeaj`k ahar]`]o+

Eh kjmo\i^d\ ^g}id^\7 _`ad^d`i^d\ _` 2\*m`_p^o\n\

Rj `aba_pk `a h] ]_pere`]` `a h] ajvei] 2]*na`q_p]o] _kj`e_ekj] qj] iajkn oÄjpaoeo
`a `ede`nkpaopkopankj] %AEQ&+ Bopko ej`ere`qko iqaopn]j qjko cajep]hao ejpanjko
jkni]hao %lknmqa ah `ao]nnkhhk ] l]npen `ah _kj`q_pk `a Tkhbb `alaj`a `a hko
]j`nÇcajko&) lank cajep]hao atpanjko jk i]o_qhejko) u _kj bna_qaj_e] okj _kjbqjú
`e`ko _kj iqfanao ]h j]_an+

Rî= @A I=@QN=?EïJ @AH AOLANI=PKVKE@A

Qn]o oan pn]jolknp]`k ] h] na` paope_qh]n ] pn]r~o `ah pÉ^qhk na_pk `a _kjateÇj
%bec+ /.*0&) ah aolani]pkvke`a lajapn] aj hko _kj`q_pehhko abanajpao+ Bopko _kja_p]j
h] na` paope_qh]n _kj ah oaciajpk eje_e]h `ah ale`Ä`eik) qj _kj`q_pk ennacqh]n _kjú
pknja]`k mqa oa atpeaj`a d]op] ah _kj`q_pk `abanajpa+
Iko pÉ^qhko na_pko oa hk_]hev]j aj ah ia`e]opejk paope_qh]n u aop}j naraope`ko `a
qj alepahek _É^e_k oeilha) _kj n]ocko aopnq_pqn]hao l]na_e`ko ] h]o _~hqh]o `a Panpkhe)
o]hrk lknmqa peajaj qjekjao k_hqoer]o aj ah `kiejek ]le_]h) aj hqc]n `a aj ah ^]o]h+
Kk ateopaj _~hqh]o aolani]pkc~je_]o+
I] na` paope_qh]n aop} _kjopepqe`] lkn qj] oanea `a _]j]hao ]j]opkiko]`ko `a
bkni] ennacqh]n `ajpnk `ah ia`e]opejk paope_qh]n %bec+ /.*1&+ Bopko _]j]hao aop}j
_q^eanpko lkn qj alepahek _É^e_k oeilha+ I] l]na`) bkni]`] lkn be^nk^h]opko u _~hqh]o

3/- E Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\

booksmedicos.org
 Bdbpm\ /.*1+ U9B:0v79qF PF6 F0vF9éBq7x7fPF | 9FB,079Mf»: PF 6J8ZfP7 F: F6 M7:PZMqf667 F1F9F:qF | F6 FvfPJPfé7 v972féB6

PÉ]pgj n`hdiÄa`mj .í N`_ o`nod^pg\m*

Ag `nk`mh\ojujd_` m`^jbd_j _` g\ m`_ o`nod^pg\m
hp`nom\ pi _~]dg hjqdhd`ioj qd]m\ojmdj _` g\ ^jg\+ H\ m`_ o`nod^pg\m `no} m`q`nod_\ _` `kdo`gdj
^É]d^j ndhkg`+ H\ npk`mad^d` \kd^\g _` g\n ^~gpg\n
`kdo`gd\g`n ^jiod`i` hd^mjq`ggjnd_\_`n t pi ^dgdj
Lmjo`di\ om\inkjmo\_jm\ Éid^j+
_` \i_mÇb`ijn %=>L&
H\ kmjo`}i\ om\inkjmo\_jm\ _` \i_mÄb`ijn)
r kmj_p^d_\ kjm g\n ^~gpg\n _` O`mojgd) n` pi` \ gjn
\i_mÇb`ijn+ Ag ^jhkg`ej kmjo`Äi\*`no`mjd_`
\k\m`^` `i g\ gpu _` g\ m`_ o`nod^pg\m t gjn
n`bh`iojn did^d\g`n _`g `kd_Ä_dhj+ Ai
^jin`^p`i^d\) g\ m`_ o`nod^pg\m ^jiod`i` pi\
h\tjm ^ji^`iom\^dÇi _` \i_mÇb`ijn lp` g\
n\ibm` \mo`md\g+ Hjn \i_mÇb`ijn diom\gphdi\g`n
k\m`^`i a\qjm`^`m g\ api^dÇi ijmh\g _` g\
^\]`u\ _`g `kd_Ä_dhj+

R\mdjn ^ji_p^odggjn `a`m`io`n n` jmdbdi\i `i g\

m`_ o`nod^pg\m t kjno`mdjmh`io` ^jiagpt`i ^ji `g
^ji_p^oj `kd_d_dh\mdj hpt kg`b\_j+
Hjn ^ji_p^odggjn `a`m`io`n `no}i m`q`nod_jn
_` pi `kdo`gdj ^ji pi h\mb`i a`noji`\_j
^\m\^o`mÄnod^j+
Ag `kdo`gdj ^jhkm`i_` _jn odkjn ^`gpg\m`n7
. & ^|gpg\n kmdi^dk\g`n ^ji hd^mjq`ggjnd_\_`n) t

?~gpg\n kmdi^dk\g`n /& ^|gpg\n ^dgd\_\n+ Hjn ^dgdjn) lp` ]\o`i cd\^d\
^ji `no`m`j^dgdjn `g `kd_Ä_dhj) kmjkpgn\i `g `nk`mh\ojujd_` lp`
gg`b\+

H\ h`h]m\i\ kg\nh}od^\ a`
_`g `nk`mh\ojujd_` n p am` [[[ .* Z ?~gpg\ ]\n\g
^\h]djn k\m\ ^jhkg`o\m
np h\_pm\^dÄi+ ?~gpg\ kmdi^dk\g
Ano`m`j^dgdjn

=ph`io\ `g bmjnjm _` g\
Ag `kdo`gdj ^dgdi_md^j n`p_j`nom\odad^\_j
^\k\ _` hÉn^pgj gdnj+
^jhkm`i_` _jn odkjn ^`gpg\m`n kmdi^dk\g`n7
.& ^|gpg\n kmdi^dk\g`n ^ji `no`m`j^dgdjn) t
/ & ^|gpg\n ]\n\g`n+
O` m`^jij^`i jomjn odkjn ^`gpg\m`n n`*
Ag `nk`mh\ojujd_` ^pi_\mdjn %^~gpg\n \kd^\g`n t ^g\m\n&+
m`^jbd_j _` g\
kjm^dÇi o`mhdi\g _`g
Asdno`i _da`m`i^d\n m`bdji\g`n `i g\ jmb\idu\^dÇi _` g\ ^\k\ _` hÉn^pgj gdnj) m`nkjin\]g` _` g\n
^ji_p^oj `kd_d_dh\mdj
^jiom\^^dji`n k`mdno}god^\n mÄohd^\n lp` _`nkg\u\i `g `nk`mh\ojujd_` kjm `g ^ji_p^oj `kd_d_dh\mdj+
%^jg\& hp`nom\
H\n kjm^dji`n did^d\g`n _`g ^ji_p^oj `kd_d_dh\mdj `no}i mj_`\_\n kjm ^~gpg\n hpn^pg\m`n gdn\n
hjqdgd_\_ \io`mÄbm\_\+
_dnkp`no\n _` ajmh\ ^dm^pia`m`i^d\g+
H\n kjm^dji`n o`mhdi\g`n %^p`mkj t ^jg\& hp`nom\i ^\k\ hpn^pg\m gdn\ dio`mi\ ^dm^pg\m _` bmjnjm
^\_\ q`u h\tjm t \k\m`^` pi\ ^\k\ _` hÉn^pgj gdnj gjibdop_di\g `so`mi\+

?p`mkj

Akd_}_dhj
I(#5) ã
Ag ^ji_p^oj `kd_d_dh\mdj) hpt kg`b\_j t _` 1*3 ^h _`
gjibdop_) ^jhkm`i_` om`n m`bdji`n `n`i^d\g`n7 . & g\ ^\]`u\8
Sf+
/& `g ^p`mkj) t 0& g\ ^jg\+ H\ ^jg\ n` ^jiodiÉ\ _`g ^ji_p^oj ?ji_p^oj
_`a`m`io`+ _`a`m`io`
?\]`u\

ieke`ao) aop} nk`a]`] lkn cn]j`ao _]j]hao hejb}pe_ko u r]oko o]jcqÄjako ]ok_e]`ko ]
cn]j`ao ]cnac]`ko `a _~hqh]o `a Iau`ec+
Rjko ./*/- _kj`q_pehhko abanajpao qjaj h] na` paope_qh]n _kj ah ale`Ä`eik pn]o
]pn]rao]n h] pÉje_] ]h^qcÄja] paope_qh]n+ @]`] _kj`q_pehhk aop} naraope`k `a qj alepahek
_ehej`ne_k aj ah mqa h]o _~hqh]o lnej_el]hao peajaj ie_nkrahhkoe`]`ao) mqa `aoailaÅ]j

/ . + PN = JOLK N PA U ERE=@ Q N =? Eï J @AH AOLANERE=PKVKE@A E 3/.

booksmedicos.org
 Bdbpm\ /.*2+ AvfPJPfé7

H\n ^~gpg\n kmdi^dk\g`n n`^m`o\i ^\midodi\) {^d_j nd{gd^j)
bgp^jkmjo`}i\n t bggj`mdgajnajmdg^jgdi\ c\^d\ g\ gpu _`g
`kd_Ä_dhj+ Ag `kdo`gdj _`g `kd_Ä_dhj _`k`i_` _` gjn \i_mÇb`ijn+
Ag _jhdidj \kd^\g _` g\n ^~gpg\n ^dgdi_md^\n kmdi^dk\g`n
hp`nom\ hd^mjq`ggjnd_\_`n g\mb\n dihÇqdg`n) gg\h\_\n
`no`m`j^ggdjn+ Hjn `no`m`j^dgdjn nji g\mbjn t m\hdad^\_jn `i g\
m`bdÇi _` g\ ^\]`u\ _`g `kd_Ä_dhj) k`mj np \gopm\ n` m`_p^` `i
g\ m`bdÇi _` g\ ^jg\+

R`nÄ^pg\ _` kdij^dojndn
Anomp^opm\n km`n`io`n ?p`mkj hpgodq`nd^pg\m+
`i `g ^dojkg\nh\ \kd^\g
Asdno` pi \k\m\oj _` H\n ^|gpg\n kmdi^dk\g`n od`i`i g\n
CjoÄ^pg\ _` ggkd_jn Cjgbd kmjhdi`io` t ndbpd`io`n ^\m\^o`mÄnod^\n `nomp^opm\g`n7
hÉgodkg` `i g\ m`bdÇi .& Oji \go\n `i g\ m`bdÇi _` g\ ^\]`u\
npkm\ip^g`\m+ t np \gopm\ n` q\ m`_p^d`i_j \ gj
g\mbj _`g ^ji_p^oj `kd_d_dh\mdj c\no\
Hjn gdiaj^dojn diom\`kdo`gd\g`n gg`b\m \ n`m _` ^dgdi_md^\n ]\e\n \
nji \]pi_\io`n `i oj_\n g\n ^É]d^\n `i g\ ^jg\
m`bdji`n _`g ^ji_p^oj `kd_d_dh\mdj+ /& Ai `g _jhdidj \kd^\g n` jmdbdi\i
`no`m`sdgdjn m\hdad^\_jn+
Ag iÉ^g`j `n 0& Ag ^jhkg`ej _` Cjgbd `n hpt
\g\mb\_j t `no} kmjhdi`io` `i gj^\gdu\^dÇi npkm\*
kg`b\_j+ ip^g`\m+
H\n ^|gpg\n ]\n\g`n n` \kjt\i `i 1& H\ n`^m`^dÇi _` bgp^jkmjo`Äi\n
g\ g}hdi\ ]\n\g+ ?jiod`i`i kj^jn t g\ `i_j^dojndn t kdij^dojndn nji
jmb}ipgjn+ Op api^dÇi oj_\qÄ\ ij Ag m`oÄ^pgj hpt gg\h\odq\n+
n` c\ _`adid_j ]d`i+ `i_jkg}nhd^j 2& =kmjsdh\_\h`io` `g 6-" _`g
mpbjnj n` gj^\gdu\ gÄlpd_j o`nod^pg\m `n \]njm]d_j `i
`i `g ^dojkg\nh\ gjn ^ji_p^odggjn `a`m`io`n t `i `g
?|gpg\ ]\n\g
]\n\g+ `kd_Ä_dhj kjm g\n ^~gpg\n kmdi^dk\g`n+
H\n ^|gpg\n ]\n\g`n n` \nj^d\i \
H{hdi\ ]\n\g é g\ g}hdi\ ]\n\g+
?|gpg\ kmdi^dk\g

H í í [[ * ** >
\\\\S******* * ****
?\k\ _` hÉn^pgj Hpu _`g ^ji_p^oj `kd_d_dh\mdj
gdnj ^dm^pg\m

?|gpg\n ]\n\g`n ?|gpg\ kmdi^dk\g Ano`m`j^dgdjn

x i
H $Ä$Ä

eB4

qj] bqj_eÇj aj h] na]^okn_eÇj `a hÄmqe`k `ao`a h] hqv) u p]i^e~j oa e`ajpebe_]j _~hqh]o

_ehe]`]o) mqa _kjpne^quaj ]h pn]jolknpa `ah aolani]pkvke`a ejiÇreh d]_e] ah ale`Äú
`eik+ Bh alepahek iqaopn] qj i]ncaj baopkja]`k _]n]_panÄope_k mqa laniepa e`ajpeú
be_]n hko _kj`q_pehhko abanajpao %r+ bec+ /.*1&+ Aa^]fk `ah alepahek u `a oq h}iej] ^]o]h
oa e`ajpebe_] qj] `ahc]`] _]l] _en_qh]n ejpanj] `a _~hqh]o iqo_qh]nao heo]o+
Bh ale`Ä`eik ao qj pÉ^qhk iqu _kjpknja]`k %1*3 _i `a hkjcepq`& aj ah mqa hko
aolani]pkvke`ao i]`qn]j %ao `a_en) ]`mqeanaj ah l]pnÇj `a ikrehe`]` ]jpanÇcn]`k
ja_ao]nek l]n] oq _]l]_e`]` `a ba_qj`]n&+
Bh ale`Ä`eik oa `ere`a aj pnao oaciajpko lnej_el]hao7 .& h] _]^av]8 /& ah _qanlk)
u 0& h] _kh] %r+ bec+ /.*1&+

3// E Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\

booksmedicos.org
 Bdbpm\ /.*3+ í79P»: F0vF9éñqfM7

Anomjh\ _` o`ed_j \_dkjnj

?\k\ hpn^pg\m ^dm^pg\m dioC mi\
t ^jiepiodqj g\sj
?\k\ hpn^pg\m gjibdop_di\g `so`mi\
%kp`_` `sdnodm pi\ ^\k\ hpn^pg\m
gjibdop_di\g dio`mi\&

Akdo`gdj ^dgdi_md^j
nnp_j`nom\odad^\_j

H}hdi\
kmjkd\

O` kp`_`i d_`iodad^\m a\n^Ä^pgjn _`g H\ k\m`_ _` g\n q`i\n _`g

hÅn^pgj ^m`h{no`m `nomd\_j `i g\ k`mda`md\ F* kg`sj k\hkdidajmh ` hp`nom\
_`g ^jm_Çi `nk`mh}od^j+ H\ ^jiom\^^dÇi pi\ bmp`n\ ^\k\ hpn^pg\m
m`ag`e\ _`g ^m`h}no`m `i m`nkp`no\ \g amÄj ^ji om`n ^\k\n t n` kp`_`
`g`q\ gjn o`noÄ^pgjn \ pi\ kjnd^dÇi ^`m^\i\ ?jmo` om\inq`mn\g ^jiapi_dm ^ji pi\ \mo`md\)
\g \]_jh`i %api^dÄi g`mhjmm`bpg\_jm\&) _`g ^ji_p^oj
_`a`m`io`
?ji_p^oj _`a`m`io`

Bh alepahek ao _ehej`ne_k oaq`kaopn]pebe_]`k _kj aopanak_eheko h]ncko u n]iebe_]`ko+

?p\_mj /.*> v ? j i _ p ^ o\ ` k d_ d_ dh \ mdj
Ag `kd_Ä_dhj m`\gdu\ om`n api^dji`n kmdi^dk\g`n7
Ü Pm\inkjmo` _`g `nk`mh\ojujd_` h`_d\io` k`mdna\g*
odnhj ad\na\ g\ m`bdÇi _` \gh\^`i\hd`ioj) g\ ^jg\ _`g
`kd_Ä_dhj+ Ag od`hkj lp` o\m_\ `i h\_pm\m `g `nk`mh\oj*
ujd_` `i `g `kd_Ä_dhj jn^dg\ `iom` gjn / t gjn ./ _Ä\n+
Ü =gh\^`i\hd`ioj _`g `nk`mh\ojujd_` c\no\ g\ `t\^p*
g\^dÇi+
Ü I\_pm\^dÄi _`g `nk`mh\ojujd_`+ Hjn `nk`mh\ojujd*
_`n m`^jbd_jn _` g\ m`bdÇi _` g\ ^\]`u\ _`g `kd_Ä_dhj ij
kp`_`i a`^pi_\m+ H\ ^\k\^d_\_ _` a`^pi_\^dÇi n`
\_lpd`m` _`n_` `g ^p`mkj \ g\ ^jg\ _`g `kd_Ä_dhj+
H\ h\_pm\^dÇi _`g `nk`mh\ojujd_` di^gpt`7
.+ Ano\]dgdu\^dÇi _` g\ ^mjh\adi\ ^ji_`in\_\+
/+ ?\h]djn `i g\n ^\mb\n _` npk`mad^d` _` g\ h`h]m\i\
kg\nh}od^\+
0+ =_lpdnd^dÇi kjm `g `nk`mh\ojujd_` _` ip`q\n kmjo`Ä*
i\n _` npk`mad^d`+
1+ =_lpdnd^dÇi _` hjqdgd_\_ \ia`mÇbm\_\ _`g `nk`mh\*
ojujd_`+
à Ag _`n\mmjggj _` gjn ^ji_p^ojn `kd_d_dh\mdjn) _`mdq\_jn
_`g ^ji_p^oj _` Sjgaa) i`^`ndo\ _` g\ `skm`ndÇi ijmh\g _`
gjn b`i`n _` g\ cjh`j^\e\ 9+* #?dmVN$ t ?dmV++( H\n
hpo\^dji`n _` gjn b`i`n lp` ^j_dad^\i g\n kmjo`Äi\n
hjmajb~id^\n Çn`\n %>hk& 1 )4 t 5 ^\pn\i pi _`a`^oj `i
g\ _da`m`i^d\^dÇi _` n`bh`iojn `nk`^Äad^jn _`g ^ji_p^oj
`kd_d_dh\mdj+
Bopa alepahek _kilnaj`a `ko pelko aoaj_e]hao `a _~hqh]o %bec+ /.*2&7
.+ @~hqh]o lnej_el]hao _ehej`ne_]o) mqa r]j `ao`a h] hqv ] h] h}iej] ^]o]h+ Bj oq
`kiejek ]le_]h oa aj_qajpn]j aopanak_eheko n]iebe_]`ko u qj ]l]n]pk `a Dkhce `ao]ú
nnkhh]`k) heokoki]o u raoÄ_qh]o+
/ + @~hqh]o ^]o]hao ]ok_e]`]o ] h] h}iej] ^]o]h+ Pkj _kjoe`an]`]o lna_qnoknao
ej`ebanaj_e]`ko `a h]o _~hqh]o lnej_el]hao+
Lpnko pelko _ahqh]nao okj h]o _~hqh]o ]le_]hao) ne_]o aj iepk_kj`ne]o u mqa lna`kú
iej]j aj h] _]^av] `ah ale`Ä`eik) u h]o _~hqh]o _h]n]o) mqa lna`kiej]j aj h] _kh]+
Pa aj_qajpn]j hejbk_epko ejpn]alepahe]hao lkn pk`k ah ale`Ä`eik+ Bopko lqa`aj oan
qj _kilkjajpa eilknp]jpa `a h] ^]nnan] ejiqjkhÇce_] ale`e`ei]ne]+
I] ]hpqn] `ah alepahek r]nÄ] aj bqj_eÇj `ah oaciajpk `ah ale`Ä`eik+ Bh alepahek
ao i}o ]hpk aj h] _]^av] u i}o ^]fk aj h] _kh]+ Mkn ah _kjpn]nek) h] hqv `ah ale`Ä`eik ao
aopna_d] aj h] _]^av] u i}o ]ilhe] aj h] _kh]+
Rj] _]l] `a pafe`k iqo_qh]n heok _en_qh]n ejpanj]) _quk aolaokn ]qiajp] `ao`a
h] _]^av] ] h] _kh]) u kpn] hkjcepq`ej]h atpanj]) mqa oa na_kjk_a ] l]npen `ah _qanlk)
nk`a]j ]h alepahek u h] h}iej] ^]o]h+ I] _]l] iqo_qh]n na]hev] qjko ikreieajpko
laneop}hpe_ko l]n] b]_ehep]n ah pn]jolknpa `ah aolani]pkvke`a ] hk h]nck `ah ale`Ä`eik
%r+ _q]`nk /.*?&+
Bh _kj`q_pk `abanajpa ao qj pq^k iqo_qh]n `a 12 _i `a hkjcepq` _kj h]o
oecqeajpao _]n]_panÄope_]o7 . & ah alepahek `a naraopeieajpk ao _ehej`ne_k oaq`kaopn]pebeú
_]`k _kj aopanak_eheko) l]na_e`k ]h ale`e`ei]nek) u oa ]lku] aj qj] h}iej] lnkle]
`a pafe`k _kjfqjperk _kj be^n]o ah}ope_]o8 / & h] l]na` iqo_qh]n _kilnaj`a qj] _]l]
ejpanj] u kpn] atpanj] `a iÉo_qhk kneajp]`k aj oajpe`k hkjcepq`ej]h) oal]n]`]o
]i^]o lkn qj] _]l] ejpania`e] _en_qh]n) u 0& h] _]l] atpanj] aop} _kjopepqe`] lkn
qj pafe`k _kjfqjperk h]tk u _~hqh]o ]`elko]o+
>`ai}o `ah _kj`q_pk `abanajpa) aj ah _kn`Çj aolani}pe_k oa na_kjk_aj h]o
oecqeajpao aopnq_pqn]o %bec+ / . *3 &7 . & iÉo_qhk _nai}opan8 / & ]npane]o %]npane] aolan*
i}pe_]) ]npane] _nai]op~ne_] u ]npane] l]n] ah _kj`q_pk `abanajpa&8 0& raj]o `ah lhatk
l]ilejebknia) u 1& janreko %n]i] cajep]h `ah janrek cajepkbaikn]h) janrek _nai]o*
p~ne_k u n]i]o oeil}pe_]o `ah lhatk paope_qh]n&+ Qk`]o aop]o aopnq_pqn]o aop}j nk`a]`]o
lkn qj pafe`k _kjfqjperk h]tk+
I] ]ilkhh]) h] naceÇj `eh]p]`] `ah _kj`q_pk `abanajpa) ]_]^] `ena_p]iajpa aj h]
lnÇop]p]+ Bh atpnaik `eop]h na_e^a hko _kj`q_pko `a h] raoÄ_qh] oaiej]h) mqa bkni]j
hko _kj`q_pko au]_qh]`knao) hko _q]hao ]pn]reao]j h] lnÇop]p] l]n] `naj]n oqo oa_naú
_ekjao aj h] qnapn] lnkop}pe_] ] h] ]hpqn] `ah _khÄ_qhk oaiej]h+

/ . + PN = JOLK N PA U I = @ Q N = ? Eï J @AH AOLAN I = PK VK E@ A E 3/0

booksmedicos.org
 Bdbpm\ /.*4+ jF0JMZ6B 0Féf:B6

R`n}^pg\ n`hdi\g = bm\i \ph`ioj) `g `kdo`gdj _` g\ q`nÄ^pg\ n`hdi\g `n _` ^dgdi_md^j ndhkg` \

?\k\ hp^jn\ hpt kd`b\_\+ Hjn kgd`bp`n `kdo`gd\g`n
kmdh\mdjn n` m\hdad^\i `i kgd`bp`n n`^pi_\mdjn t
o`m^d\mdjn+
Wí ?}knpg\ Hjn kgd`bp`n `kdo`gd\g`n n` \kjt\i `i pi o`ed_j
_` o`ed_j ^jiepiodqj g\sj %g}hdi\ kmjkd\ _` g\ hp^jn\&+
^jiepiodqj
n`p_j`nom\odad^\_j+
Ag ^dojkg\nh\ \kd^\g `n q\^pjg\_j t ^jiod`i` bm}ipgjn _` n`^m`^dÇi+
H\n q`nÄ^pg\n n`hdi\g`n ^jiomd]pt`i ^ji h}n _` g\ hdo\_ _`g qjgph`i _`g
n`h`i+ H\n q`nÄ^pg\n n`hdi\g`n ij \gh\^`i\i `nk`mh\ojujd_`n+
H\ n`^m`^dÇi n` ^jhkji` _` amp^ojn\) kmjno\bg\i_di\n t kmjo`}i\n `nk`^}ad*
^\n _` g\n q`n}^pg\n n`hdi\g`n %kmjo`}i\n ^j\bpg\io`n&+

í K ?\k\n hpn^pg\m`n gjibdop_di\g `so`mi\

H{hdi\ kmjkd\

Cg{i_pg\n b`ido\g`n \^^`njmd\n

I]o ch}j`qh]o ]__aokne]o `ah ]l]n]pk nalnk`q_pkn i]o_qhejk _kilnaj`aj `ko raoÄú
_qh]o oaiej]hao) h] lnÇop]p] u `ko ch}j`qh]o ^qh^kqnapn]hao `a @kslan+ I]o raoÄ_qh]o
oaiej]hao u h] lnÇop]p] lnk`q_aj h] i]ukn l]npa `ah hÄmqe`k oaiej]h u oq bqj_eÇj ao
nacqh]`] lkn hko ]j`nÇcajko %paopkopankj] u AEQ&+

RAOî?QH=O OAIEJ=HAO
I]o raoÄ_qh]o oaiej]hao okj Çnc]jko `alaj`eajpao `a ]j`nÇcajko+ @]`] raoÄ_qh]
oaiej]h peaja pnao _kilkjajpao %bec+ /.*4&7 .& qj] _}loqh] `a pafe`k _kjfqjperk
atpanj]8 / & qj] _]l] `a iÉo_qhk heok ejpania`e] %_]l]o _en_qh]n ejpanj] u hkjcepqú
`ej]h atpanj]&) u 0& qj] iq_ko] ejpanj] i qu lhac]`] naraope`] `a qj alepahek `a
_ehej`ne_k oaq`kaopn]pebe_]`k ] _É^e_k oeilha+
I]o _~hqh]o alepahe]hao iqaopn]j qj cn]j ]l]n]pk `a Dkhce) _kj raoÄ_qh]o mqa
_kjpeajaj cn}jqhko oa_napknao+ I]o raoÄ_qh]o oaiej]hao oa_nap]j qj hÄmqe`k ]h_]hejk
reo_kok ne_k aj lnkpaÄj]o `a h] _k]cqh]_eÇj) bnq_pko] u lnkop]ch]j`ej]o oaiej]hao+
Bopa hÄmqe`k _kjpne^qua ]lnktei]`]iajpa ]h 4-*52" `ah au]_qh]`k dqi]jk+
I] bnq_pko] ao h] lnej_el]h bqajpa `a ajancÄ] l]n] ah aolani]pkvke`a au]_qh]`k+
I]o raoÄ_qh]o oaiej]hao jk ]hi]_aj]j aolani]pkvke`ao u oa _kjpn]aj `qn]jpa h]
au]_qh]_eÇj+ Bh _kj`q_pk at_napkn `a _]`] raoÄ_qh] oaiej]h ajpn] aj h] lnÇop]p] pn]o
qjenoa _kj ah _kj`q_pk `abanajpa l]n] bkni]n ah _kj`q_pk au]_qh]`kn %bec+ / . * 5 &+

CHìJ@QH= LNKOPìPE?=
I] lnÇop]p] ao h] i]ukn ch}j`qh] cajep]h ]__aokne] u oa nk`a] lkn qj] _}loqh]+ @kiú
lnaj`a ajpna 0- u 2- ch}j`qh]o pq^qhk]hrakh]nao n]iebe_]`]o) mqa r]_Ä]j oq _kjpaú
je`k aj h] qnapn] lnkop}pe_] ] pn]r~o `a qjko _kj`q_pko at_napknao h]ncko+

3/1 E Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\

booksmedicos.org
 Bdbpm\ I cge í7:PZMq70 F|BMZ6BP79F0

Hjn ^ji_p^ojn _` g\n q`nÄ^pg\n n`hdi\g`n \om\qd`n\i g\ ^}knpg\ _` g\ bg}i_pg\

kmjno}odj\ t n` pi`i \g ^ji_p^oj _`a`m`io` _`g hdnhj g\_j k\m\ ajmh\m `g ^ji_p^oj
`t\^pg\_jm+
Ag ^ji_p^oj `t\^pg\_jm _`n`h]j^\ `i g\ k\m`_ kjno`mdjm _` g\ pm`om\ kmjno}od^\+ ?ji_p^oj
H\ k\m`_ _`g ^ji_p^oj `t\^pg\_jm `no} kg`b\_\ t m`q`nod_\ _` pi `kdo`gdj ^dgdi_md^j _`a`m`io` R`nÄ^pg\ n`hdi\g
ndhkg` mj_`\_j _` o`ed_j ^jiepiodqj t c\^`n _` hÉn^pgj gdnj+

=hkjgg\ _`g
^ji_p^oj
_`a`m`io`

Qm`om\
kmjno}od^\
Qm`om\ k`id\i\

I]o ch}j`qh]o lnkop}pe_]o oa `ere`aj aj pnao nacekjao %bec+ /.*6&7 .& qj] vkj]
_ajpn]h _kj ch}j`qh]o iq_ko]o laneqnapn]hao8 / & qj] vkj] `a pn]joe_eÇj _kj ch}j`qh]o
oq^iq_ko]o laneqnapn]hao) u 0& qj] vkj] laneb~ne_] _kj ch}j`qh]o n]iebe_]`]o %_kiú
lqaop]o&+ >lnktei]`]iajpa ah 4-*5-" `a hko _]n_ejki]o `a h] lnÇop]p] peajaj oq
knecaj aj h] vkj] laneb~ne_]+
I]o ch}j`qh]o lnkop}pe_]o aop}j naraope`]o `a alepahek _ehej`ne_k oeilha k oaq`kao*
pn]pebe_]`k %bec+ /.*.-&+ I] hqv _kjpeaja oa_na_ekjao lnkop}pe_]o %_qanlko ]ieh}_ako&)
ne_ko aj chq_klnkpaÄj]o u mqa) aj k_]oekjao) _kjpeajaj `alÇoepko `a _]h_ek+ Bj h]o
_~hqh]o d]u qj napÄ_qhk aj`klh}oie_k heok ]^qj`]jpa u qj ]l]n]pk `a Dkhce+
I] lnÇop]p] lnk`q_a qj hÄmqe`k ]h_]hejk ne_k aj _ej_) mqa jaqpn]hev] ah _kjpaje`k
}_e`k r]cej]h) ]lknp] jqpneajpao) u pn]jolknp] ]h aolani]pkvke`a u d]_a ah oaiaj i}o
hÄmqe`k+
Iko lnk`q_pko lnkpae_ko okj h] bkob]p]o] }_e`] aola_Äbe_] `a h] lnÇop]p]) ah
]jpÄcajk lnkop}pe_k aola_Äbe_k %MP>) qj i]n_]`kn r}he`k l]n] h] `apa__eÇj lna_kv
`ah _}j_an `a lnÇop]p]&) h] ]ieh]o] u h] be^nejkheoej]+

Eh kjmo\i^d\ ^g}id^\7 cdk`mkg\nd\ kmjno{od^\ ]`idbi\ t ^{i^`m _` kmÄno\o\

I] delanlh]oe] lnkop}pe_] ^ajecj] %EM?& _kjoeopa aj qj ]qiajpk `a p]i]Åk jk
i]hecjk `a h] lnÇop]p] mqa lqa`a `ebe_qhp]n ah bhqfk `a knej] ] pn]r~o `a h] qnapn]
lnkop}pe_]+
I]o ch}j`qh]o lnkop}pe_]o iq_ko]o %vkj] _ajpn]h& u oq^iq_ko]o %vkj] `a pn]joeú
_eÇj& laneqnapn]hao u ah aopnki] oqbnaj qj] delanlh]oe] jk`qh]n %r+ bec+ /.*6& aj hko
]j_e]jko+
I] delanlh]oe] jk`qh]n k_]oekj]7
.+ Aebe_qhp]` l]n] h] ie__eÇj u k^opnq__eÇj qnej]ne] _]qo]`] lkn h] _kilnaoeÇj
`a h] qnapn] lnkop}pe_] lkn ah _na_eieajpk jk`qh]n+
/+ Oapaj_eÇj `a h] knej] aj h] rafec] k ej_]l]_e`]` l]n] r]_e]n h] rafec] qnej]ne]
lkn _kilhapk+ I] lkoe^ehe`]` `a ejba__eÇj k_]oekj] ejbh]i]_eÇj `a h] rafec] qneú
j]ne] %_eopepeo& a ejba__eÇj naj]h %leahkjabnepeo&+ Rj] napaj_eÇj qnej]ne] ]cq`] u
lanoeopajpa k^Rc] ] qj okj`]fa qnej]nek `a qncaj_e]+
I] EM? oa lnk`q_a lkn AEQ) qj iap]^khepa `a h] paopkopankj] %bec+ /.*..&+ I]
ajvei] 2]*na`q_p]o]) lnaoajpa bqj`]iajp]hiajpa aj h]o _~hqh]o aopnki]hao lnkop}ú
pe_]o) _kjreanpa h] paopkopankj] aj AEQ+
/ . + PN = JOLK N PA U I = @ Q N = ? Eï J @AH AOLAN I = PK VK E@ A E 3/2

booksmedicos.org
 Bdbpm\ /.*6+ L6ñ:PZ6B v970qVqfMB

Cg{i_pg\n %uji\ ^`iom\g&

Cg{i_pg\n %uji\ _` om\ind^dÄi&

Hpb\m _` jmdb`i _` g\ cdk`mkg\nd\
kmjno~od^\ ]`idbi\ %DL>&

Qm`om\ kmjno~od^\
?m`no\ pm`om\g

Vji\ k`mda~md^\

Hpb\m `i `g lp` n`
jmdbdi\ `g ^}i^`m _`

@jn h\m^\_jm`n ]djlpÄhd^jn n` `hkg`\i k\m\ `g _d\biÇnod^j t g\

hjidojmdu\^dÇi _`g om\o\hd`ioj _`g ^\m^dijh\ _` kmÇno\o\7 . & ajna\o\n\
{^d_\ kmjno|od^\) t /& \io}b`ij kmjno|od^j `nk`^}ad^j %LO=&+

Ddk`mkg\nd\ kmjno|od^\ ]`idbi\

b ^

Qm`om\ kmjno~od^\

@ Ai g\ DL> n` ajmh\i iÇ_pdjn `i g\ m`bdÇi k`mdpm`om\g _` g\
kmjno\o\+ Hjn ij_pgjn _` bm\i o\h\Åj kp`_`i ^jhkmdhdm g\ pm`om\ t
j^\ndji\m j]nomp^^dÇi pmdi\md\+ M DdnojgÇbd^\h`io`) g\n bg}i_pg\n
kmjno~od^\n `no}i \ph`io\_\n _` o\h\Åj t np `kdo`gdj \k\m`^`
kg`b\_j+ M O` j]n`mq\i ^p`mkjn \hdg}^`jn `i g\n gp^`n bg\i_pg\m`n+
H\ _dcd_mjo`nojno`mji\ %@DP& _`mdq\_\ _` g\ o`nojno`mji\ kjm \^^dÇi _` g\
2\*m`_p^o\n\ kp`_` \^op\m nj]m` g\n ^~gpg\n `nomjh\g`n t `kdo`gd\g`n
bg\i_pg\m`n k\m\ di_p^dm g\ ajmh\^dÇi _` iÇ_pdjn kmjno~od^jn+ U\ lp` g\
2\*m`_p^o\n\ n` `i^p`iom\ `i g\n ^~gpg\n `nomjh\g`n) k\m`^` lp` `no`
^jhkji`io` ^`gpg\m kp`_` m`npgo\m `n`i^d\g `i g\ \k\md^dÇi _` @DP t _` g\ DL>+

3/3 E Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\

booksmedicos.org
booksmedicos.org
 Bdbpm\ I c Ie á9Fq9B0 éB0MZ6f:B | 1FéF:f:B

L`i`

Ag k\i` ^jhkm`i_` om`n mm\n\n ^dgdi_md^\n lp` ^jiod`i`i o`ed_j `m|^odg7 .& _jn ^p`mkjn
^\q`mijnjn) t / & pi ^p`mkj `nkjiejnj Éid^j) lp` mj_`\ g\ pm`om\ k`id\i\ t o`mhdi\ `i `g
bg\i_` ^Çid^j) Ano\n om`n h\n\n ^dgdi_md^\n `no}i mj_`\_\n kjm pi o`ed_j ^jiepiodqj `g}nod^j
%g\ a\n^d\& lp` `no} ^p]d`moj _` kd`g+ ?\_\ ^dgdi_mj `no} mj_`\_j kjm pi\ ^}knpg\ _` o`ed_j
^jiepiodqj _`inj) g\ oÅid^\ \g]pb}i`\+

ù*@

R`i\ _jmn\g npk`mad^d\g

=mo`md\ _jmn\g

J`mqdj _jmn\g

R\nj n\ibpÄi`j t i`mqdj

=mo`md\ ^`iom\g
_jmn\g kmjapi_j
?p`mkjn ^\q`mijnjn

PÉid^\ \g]pbdi`\

?p`mkj `nkjiejnj

Ip^jn\ kg`b\_\ _`
g\ pm`om\ m`q`nod_\ _`
`kdo`gdj om\ind^dji\g
%pmjo`gdj&

R\nj n\ibpÄi`j

IÉn^pgj gdnj

IÉn^pgj `nomd\_j

Cg}i_pg\n
hp^jn`^m`ojm\n

Fcq]h mqa oq_a`a _kj h] EM?) hko ]j`nÇcajko ejpanreajaj p]i^e~j aj ah `ao]nnkú
hhk `ah _]n_ejki] `a lnÇop]p]+ Bh _na_eieajpk `ah pqikn oa lqa`a _kjpnkh]n na`qú
_eaj`k h] lnk`q__eÇj `a ]j`nÇcajko %l+ af+) qpehev]j`k ]ckjeop]o `a h] dknikj]
he^an]`kn] `a dknikj] hqpaejev]jpa %IEOE& u ]jpe]j`nÇcajko& k) aj hko pqiknao
naoeopajpao ] h]o dknikj]o) _kj qj] knmqea_pkiÄ] %naoa__eÇj mqenÉnce_] `a hko paopÄú
_qhko) mqa okj h] bqajpa lnej_el]h `a ]j`nÇcajko& u mqeiekpan]le]+
I] _enqcÄ] %lnkop]pa_pkiÄ] n]`e_]h lkn rÄ] napnklÉ^e_] k laneja]h& u h] n]`ekpan]le]
%ia`e]jpa d]v atpanjk k _kj eilh]jpa `a oaiehh]o n]`e]_per]o aj h] lnÇop]p]& okj
kl_ekjao ]`a_q]`]o l]n] pqiknao hk_]hev]`ko aj hko aopq`eko n]`ekhÇce_ko
_kilqp]nev]`ko+

bIg K Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\

booksmedicos.org
 Bdbpm\ /.*.0+ EFMB:f0é7 PF 6B F9FMMf»: vF:fB:B

M Hjn i`mqdjn kmj_p^`i Äsd_j i}omd^j %JK&) Cp\idg\oj `d^d\n\
lp` _dapi_` c\^d\ g\n ^|gpd\n _`d hÅn^pdj ddnj
lp` mj_`\ gjn ndipnjd_`n _` n\ibm` _`g o`ed_j
`m~^odg k`id\ij+ H\n hjg~^pg\n _` JK nji om\in*
kjmo\_\n _`nkp~n \ jom\n ^~gpg\n hpn^pg\m`n
gdn\n h`_d\io` pidji`n ^jhpid^\io`n+
Ksd_j i}omd^j
M H \ n hjg~^pg\n _` JK \^odq\i g\ bp\idd\oj ^d^d\n\) lp`
^jiqd`mo` `g omdajna\oj _` bp\ijndi\ %CPL& `i hjijajna\oj _`
Eí ?~gpg\ hpn^pg\m gdn\ bp\ijndi\ ^Ä^gd^j %^CIL&+
QidÇi M Ag ^CIL kji` `i h\m^ad\ `g \dh\^`i\hd`ioj _` ?\Z$Z _`iomj
^jhpid^\io` _` d\ ^|gpd\ %n`^p`nomj&+ Qi\ ]\e\ ^ji^`iom\^dÇi _` ?\Z' di_p^` g\
m`g\e\^dÇi _` g\ \^odi\ t g\ hgjngi\+
M Ag hÉn^pgj gdnj m`g\e\_j km`ndji\ g\n k`lp`Å\n q`i\n lp`
$ CPL Z i \ i g\ n\ibm` _`g k`i`+ H\ n\ibm` n` \^phpg\ `i gjn ndipnjd_`n
@][>) t `g k`i` n` kji` `m`^oj+ H\ ajnaj_d`no`m\n\ _`bm\_\ `g ^CIL t

p e)
[*N o`mhdi\ g\ `m`^^dÇi+

^CIL
L\m`_ hpn^pg\m gdn\ í í O\ibm` `i g\ gpu _` pi ndipnjd_`

H\ n\ibm` \^phpg\_\ `i g\ gpu _`g

ndipnjd_` kjm g\ m`g\e\^dÇi hpn^pg\m
^jhkmdh` pi\ q`i\ k`lp`Å\ `
dhkd_` `g _m`i\e` _` n\ibm` _` gjn
Hpu _`g
ndipnjd_`n+
t ndipnjd_`

?~gpg\ Eí ?~gpg\ `i_jo`gd\g

hpn^pg\m
gdn\ Odipnjd_`

J`mqdj kp_`i_j
R`i\ k`lp`Å\ ^jhkmdhd_\

QNAPN=O I=O?QHEJ= U BAIAJEJ=

I] qnapn] `ah r]nÇj ie`a /- _i `a hkjcepq` u peaja pnao oaciajpko7
.+ I] qnapn] lnkop}pe_]) mqa na_e^a lnk`q_pko pn]jolknp]`ko lkn ah _kj`q_pk
au]_qh]`kn u hko _kj`q_pko `a h]o ch}j`qh]o lnkop}pe_]o+
/+ I] qnapn] iai^n]jko]) mqa ao h] vkj] i}o _knp]+
0+ I] qnapn] laje]j]) mqa na_e^a hko _kj`q_pko `a h]o ch}j`qh]o ^qh^kqnapn]hao
% adb + / . * . / & +

Bh alepahek `a h] qnapn] lnkop}pe_] ao pn]joe_ekj]h %qnkpahek&+ @]i^e] `a alepahek

oaq`kaopn]pebe_]`k ] _ehej`ne_k aopn]pebe_]`k aj h] qnapn] iai^n]jko] u laje]j]+ I]
_]l] iqo_qh]n `a h] qnapn] iai^n]jko] _knnaolkj`a ] qj aobÄjpan iqo_qh]n heok
%ejrkhqjp]nek& u kpnk aopne]`k %rkhqjp]nek&) mqa _kjpnkh]j h] aheiej]_eÇj `a h] knej]
k ah oaiaj+
I] qnapn] baiajej] ie`a 1 _i `a hkjcepq` u oa nareopa `a alepahek pn]joe_ekj]h)
mqa arkhq_ekj] ] kpnk _ehej`ne_k oaq`kaopn]pebe_]`k u ao_]ikok jk mqan]pejev]`k
aopn]pebe_]`k aj h]o lnkteie`]`ao `ah ia]pk qnapn]h+ I] iq_ko] _kjpeaja ch}j`qh]o
iq_koa_napkn]o %r+ bec+ /.*./&+ Rj] _]l] `a iÉo_qhk heok ejpanj] aop} nk`a]`] lkn
kpn] `a iÉo_qhk aopne]`k _en_qh]n) mqa _eann] h] qnapn] _q]j`k oa _kjpn]a+

CHìJ@QH=O >QH>KQNAPN=HAO
I]o ch}j`qh]o ^qh^kqnapn]hao _kilnaj`aj r]neko hk^qhehhko _kj qje`]`ao oa_napkn]o
pq^qhk]hrakh]nao u qj _kj`q_pk at_napkn lnej_el]h) naraope`k lkn qj alepahek _ehejú
`ne_k aopn]pebe_]`k+ Bh alepahek `a naraopeieajpk `a h] qje`]` oa_napkn] ao _ehej`ne_k
u oa_nap] qj i]pane]h iq_ke`a+ I] oa_na_eÇj) mqa _kjpeaja ]^qj`]jpa c]h]_pko] u
qj] _]jpe`]` ik`an]`] `a }_e`k oe}he_k) oa atlqho] d]_e] h] qnapn] laje]j]+ Bop]
oa_na_eÇj na]hev] qj] bqj_eÇj hq^ne_]jpa u lna_a`a ] h] aieoeÇj `ah oaiaj lkn h]
qnapn] laje]j]+

/ . + PN = JOLK N PA U I = @ Q N = ? Eï J @AH AOLAN I = PK VK E@ A E 3/6

booksmedicos.org
 LAJA
Bh laja _kilnaj`a pnao i]o]o _ehej`ne_]o aj bkni] `a _khqij]o `a pafe`k an~_peh
%r+ bec+ / . * . / &7 hko _qanlko _]ranjkoko `ana_dk a evmqean`k u ah _qanlk aolkjfkok
rajpn]h) ]pn]rao]`k lkn h] qnapn] laje]j]+ Bop]o pnao _khqij]o _kjrancaj l]n] bkni]n
ah _qanlk `ah laja+ Bj ah atpnaik `eop]h `ah _qanlk aolkjfkok oa aj_qajpn] ah
ch]j`a+
Iko _qanlko _]ranjkoko u ah aolkjfkok _kjpeajaj aol]_eko o]jcqÄjako ennacqh]nao
u _kiqje_]`ko) hh]i]`ko oejqoke`ao) mqa okj ennec]`ko lkn qj] ]npane] u `naj]`ko
lkn _]j]hao rajkoko+ Aqn]jpa h] ana__eÇj) h] o]jcna ]npane]h hhaj] hko oejqoke`ao) mqa
]qiajp]j `a p]i]Åk u _kilneiaj hko _]j]hao `a napknjk rajkok %bec+ /.*.0&+
Ako oqop]j_e]o mqÄie_]o _kjpnkh]j h] ana__eÇj7 ah Çte`k jÄpne_k u h] bkobk`eaopa*
n]o] %r+ bec+ /.*.0&+
.+ I] aopeiqh]_eÇj oatq]h _kj`e_ekj] mqa h]o n]i]o `ah janrek `kno]h) mqa ao h]
l]npa i}o `eop]h `ah janrek lq`aj`k) lnk`qv_]j Çte`k jÄpne_k) cn]_e]o ] oq ]__eÇj
ok^na h] _knpav] _ana^n]h u ah delkp}h]ik) ]oÄ _kik ] h]o oaÅ]hao pn]jolknp]`]o lkn h]
i~`qh] aolej]h d]op] hko janreko ]qpÇjkiko `ah laja+
I]o ikh~_qh]o `a Çte`k jÄpne_k `ebqj`aj _kj n]le`av ] pn]r~o `a qjekjao
_kiqje_]jpao `a h]o _~hqh]o iqo_qh]nao heo]o mqa nk`a]j hko oejqoke`ao o]jcqÄjako+
Aajpnk `a h]o _~hqh]o iqo_qh]nao do]o) h]o ikh~_qh]o `a Çte`k jÄpne_k ]_per]j h]
cq]jeh]pk _e_h]o] l]n] lnk`q_en ikjkbkob]pk `a cq]jkoej] _Ä_he_k %_DJM& ] l]npen
`a pnebkob]pk `a cq]jkoej] %DQM&+
Bh _DJM nah]f] h] l]na` `a _~hqh]o iqo_qh]nao heo]o mqa nk`a] hko oejqoke`ao
ej`q_eaj`k ah oa_qaopnk `ah @][[ `ajpnk `a qjko `alÇoepko ejpn]_ahqh]nao+ I] iajkn
_kj_ajpn]_eÇj `a _]h_ek `apaniej] h] nah]f]_eÇj `a h]o _~hqh]o iqo_qh]nao heo]o) hk mqa
laniepa qj] n}le`] ]_qiqh]_eÇj `a o]jcna aj hko oejqoke`ao cn]_e]o ]h rahkv bhqfk `a
h] o]jcna lkn h]o ]npane]o `kno]h u _]ranjko] %r+ bec+ /.*.0&+ Iko oejqoke`ao hhajko `a
o]jcna _kilneiaj h]o raj]o lamqaÅ]o mqa `naj]j h] o]jcna `ah laja u oa lnk`q_a
h] ana__eÇj laje]j]+
/+ I] ajvei] bkobk`eaopan]o] %MAB& oa lnk`q_a l]n] `aopnqen ah _DJM u panieú
j]n h] ana__eÇj+ >h ^hkmqa]n h] ]_pere`]` `a h] MAB) h]o _kj_ajpn]_ekjao `a _DJM
oecqaj ]hp]o u oa i]jpeaja h] ana__eÇj+

Eh kjmo\i^d\ ^g}id^\7 _dnapi^dÄi `m|^odg

Iko b]_pknao mqa ]ba_p]j ] h]o rÄ]o janreko]o `a h] _knpav] _ana^n]h*delkp}h]ik*i~`qh]
aolej]h u ] hko janreko ]qpÇjkiko) u h]o ajbania`]`ao r]o_qh]nao lqa`aj lnk`q_en
qj] `eobqj_eÇj an~_peh+ Iko pn]qi]peoiko _n]ja]hao u ia`qh]nao) ah e_pqo) h] ajbanú
ia`]` `a M]ngejokj u ajbania`]`ao oeop~ie_]o) _kik h] `e]^apao u h] ao_hankoeo
iÉhpelha) na`q_aj h] bqj_eÇj janreko] u k_]oekj]j qj] `eobqj_eÇj an~_peh+ >`ai}o)
hko pn]opknjko lkn ]joea`]` lqa`aj oan qj] _]qo] eilknp]jpa `a `eobqj_eÇj an~_peh+
Bh oeh`aj]behk oa lnk^Ç eje_e]hiajpa _kik pn]p]ieajpk `a h] ejoqbe_eaj_e] _]n`Ä]_]
u) `qn]jpa hko ajo]uko _hÄje_ko) oa k^oanrÇ mqa qj jÉiank jkp]^ha `a l]_eajpao
lnaoajp]^]j ana__ekjao pn]o na_e^en ah b}ni]_k+ Bop] k^oanr]_eÇj hharÇ ] na]dv]n qj
aopq`ek _hÄje_k ej`alaj`eajpa l]n] r]hkn]n hko aba_pko `a oeh`aj]behk _kik pn]p]ú
ieajpk `a h] eilkpaj_e]+
Bh oeh`aj]behk ^hkmqa] qj] bkobk`eaopan]o] aola_Äbe_] lnaoajpa aj h]o _~hqh]o iqoú
_qh]nao heo]o `ah laja u) ia`e]jpa aop] ]__eÇj) ^hkmqa] h] `acn]`]_eÇj `a _DJM
Rj]o _kj_ajpn]_ekjao ahar]`]o `a _DJM ej`q_aj h] ajpn]`] `a @][[ aj hko `alÇú
oepko _ahqh]nao u h] nah]f]_eÇj `a h]o _~hqh]o iqo_qh]nao heo]o laneoejqoke`]hao+
Bh oeh`aj]behk lqa`a k_]oekj]n aba_pko oa_qj`]neko `alaj`eajpao `a h] `koeo) _kik
ajnkfa_eieajpk b]_e]h) ikhaope]o `ecaoper]o) _ab]ha]o u qj] reoeÇj _kj pejpa ]vqh+

30- E Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\

booksmedicos.org
 I \k\ ^ j i ^` k op \ g v Pm\inkjmo` t h\_pm\^dÄi _`g `nk`mh \ojujd_`

Pm\inkjmo` t h\_pm\^dÄi _`g `nk`mh\ojujd_`

?ji_p^odggjn Akd_Ä_dhj ?ji_p^oj

PÉ]pgj n`hdiÄa`mj PÉ]pgj m`^oj
`a`m`io`n
/3 _`a`m`io`
ü

g
N`_ o`nod^pg\m ?\]`u\ ?p`mkj * ?jg\
E
?~gpg\n _` O`mgjgd %^dgdi_md^\n& ?~gpg\n _` O`mojgd %^É]d^\n& ?~gpg\n kmdi^dk\g`n í ?~gpg\n kmdi^dk\g`n

?~gpg\n `nk`mh\ojb~id^\n ?~gpg\n ^dgd\_\n í ?~gpg\n ]\n\g`n *

?~gpg\n hdjd_`n ?~gpg\n hdjd_`n ?\k\n _` hÉn^pgj

?\k\ _` hÉn^pgj gdnj ^dm^pg\m lp` \ph`io\ _` bmjnjm
gdnj `so`mi\
` dio`mi\
Ddk`mkg\nd\ kmjno~od^\
Akdo`gdj ^dgdi_md^j _` ndhkg` \
]`idbi\
n`p_j`nom\odad^\_j kg`b\_j ?jm_Çi `nk`mh}od^j Z
R[[[[[[[[[[[[[[[[[[[[[[[[[[[[ A i F [ F
R`nÄ^pg\n n`hdi\g`n L *K
-O
j ôL
-&
Cg}i_pg\n k`mdpm`om\g`n Vji\ ^`iom\g
O L W L W
ôj+ K
P+
Cg}i_pg\n np]hp^jn\n
í Vji\ _` om\ind^dÇië LmÇno\o\
?ji_p^ojn
=hkjgg\ E V(
j
ò?+
b
k`mdpm`om\g`n `t\^pg\_jm`n %@ d
IA
Cg}i_pg\n kmjno~od^\n kmdi^dk\g`n í Vji\ k`mda~md^\
Qm`om\

?}i^`m _` kmÇno\o\
é? * ?p`mkjn ^\q`mijnjn
P
0
òA
0
# $ ?p`mkjn `nkjiejnjn
c
5

? ji^`kojn `n`i^d\g`n v Pm\inkjmo` t h\_pm\^dÄi _`g `nk`mh \ojujd_`

à H\n ^~gpg\n b`mhdi\g`n kmdh jm_d\g`n %?CL&) lp` nji g\n
km`^pmnjm\n _` gjn b\h`ojn a`h `idijn t h\n^pgdijn) od`i`i
pi jmdb`i `som\`h ]mdji\mdj t \k\m`^`i kjm kmdh`m\ q`u `i
g\ k\m`_ _`g n\^j qdo`gdij `i gjn a`ojn _` 1 n`h\i\n+
Aiom` g\n 1 t * n`h\i\n) g\n ?CL hdbm\i \ g\n ^m`no\n
bji\_\g`n h`_d\io` g\ om\ingj^\^dÇi _`n_` `g n\^j qdo`gdij \g
dio`nodij kjno`mdjm %`i pi\ hdbm\^dÇi _`n_` `g dio`nodij
kjno`mdjm \ g\n ^m`no\n bji\_\g`n om\n \om\q`n\m `g h`n`io`mdj&
t g\ ^jgjidu\^dÇi _` g\n ^m`no\n bji\_\g`n+ Ai `no` kmj^`nj
_` hdbm\^dÇi k\mod^dk\ `g m`^`kojm ^*fdo) pi\ odmjndi\ ^di\n\) t
`g a\^ojm _` g\n ^~gpg\n h\_m`) lp` `n `g gdb\i_j _` ^*fdo+ H\
a\go\ _` m`^`kojm ^*fdo j _` np gdb\i_j ^ji_d^dji\ pi\ _`ad*
^d`i^d\ _` ?CL `i g\n ^m`no\n bji\_\g`n j g\n bÇi\_\n+
Ai g\n ^m`no\n bji\_\g`n) g\n ?CL lp` ^jiod`i`i `g ^mj*
h jnjh \ TT n` gj^\gdu\i `i g\ ^jmo`u\) h d`iom\n lp` g\n lp`
^jiod`i`i TU gj c\^`i `i g\ h ~_pg\) g\ uji\ ^`iom\g _` g\n
^m`no\n bji\_\g`n+ = k\modm _` g\n 4 n`h\i\n) g\n bÇi\_\n
di_da`m`io`n h p`nom\i pi\ ^jmo`u\) lp` n` ^jiqd`mo` `i `g
jq\mdj) t pi\ h~_pg\) lp` `qjgp^dji\ \ o`noÄ^pgj+
Ag _`n\mmjggj _`g o`noÄ^pgj n` ^jiomjg\ kjm `g a\^ojm _`o`m*
h di\io` o`nod^pg\m) pi kmj_p^oj _` pi b`i `i g\ m`bdÇi
_`o`mh di\io` _`g n`sj _`g ^mjh jnjh \ U #JIP$(
Hjn ^jh kji`io`n did^d\g`n _`g o`noÄ^pgj a`o\g nji gjn
^jm_ji`n o`nod^pg\m`n) lp` ^jiod`i`i ^~gpg\n _` O`mojgd t
km``nk`mh \ojbjid\n %gg\h\_\n o\h ]d~i bjij^dojn& _`mdq\*
_\n _` g\n ?CL H\n ^~gpg\n _` H`t_db n` `i^p`iom\i `iom`
eP gjn ^jm_ji`n o`nod^pg\m`n+ H\n ^~gpg\n _` O`mojgd a`o\g`n n`^m`*
lp` n` ^jiqd`mo` `i _dcd_mjo`nojno`mji\ %@DP& kjm g\ 2\ *
m`_p^o\n\+ H\ o`nojno`mji\ `nodh pg\ `g `som`h j ^`a}gd^j _`g
^ji_p^oj _` S jgaa %^ji_p^oj h `nji~amd^j& k\m\ lp` n`
^jiqd`mo\ `i `g `kd_Ä_dh j) `g ^ji_p^oj _`a`m`io` t g\n q`nÄ*
^pg\n n`hdi\g`n+ H\ @DP di_p^` `g _`n\mmjggj _` g\ kmÇno\o\
t g\ pm`om\ \ k\modm _`g n`ij pmjb`ido\g+ H\ o`nojno`mji\ t g\
@DP n` pi`i \g m`^`kojm _` \i_mÇb`ijn) pi\ kmjo`Äi\
^dojnÇgd^\*ip^g`\m ^j_dad^\_\ `i pi b`i _`g ^mjh jnjh \ T+
Ag n}i_mjh` _` Ggdi`a`go`m %14)TTU& \a`^o\ \ q\mji`n ^ji
pi ^mjhjnjh\ T \_d^dji\g+ Hjn di_dqd_pjn hp`nom\i a`ijodkj
h\n^pgdij) od`i`i o`noÄ^pgjn \omÇad^jn t g\n ^ji^`iom\^dji`n _`
o`nojno`mji\ `i g\ n\ibm` `no}i ]\e\n) ^ji \go\n ^ji^`iom\^dj*
i`n _` `nom\_djg+ Ag `s^`nj _` `nom\_djg ^\pn\ bdi`^jh\nod\+
Ag n}i_mjh ` _` din`ind]dgd_\_ \ \i_mÄb`ijn %OE=) _`ij*
h di\_j o\h ]d~i a`h didu\^dÇi o`nod^pg\m& qd`i` _`o`mh di\_j
kjm pi _`a`^oj k\m^d\g j ^jh kg`oj _` g\ `skm`ndÇi _`g m`^`k*
oj m _` \i_mÇb`ijn+ Anojn k\^d`io`n hp`nom\i a\go\ _` _`n\*
mmjggj _`g ^ji_p^oj _` S jgaa t m`bm`ndÇi _`g ^ji_p^oj _`
I degg` m Hjn o`noÄ^pgjn n` lp`_\i _`iomj _`g \]_jh `i t gjn
b`ido\g`n `so`mijn nji a`h `idijn+ H\n ^ji^`iom\^dji`n _`
\i_mÇb`ijn t `nom\_djg `i n\ibm` `no}i di^m`h`io\_\n+
H\ _`ad^d`i^d\ _` 2\*m`_p^o\n\ ^ji_d^dji\ pi\ h `ijm
^jiq`mndÇi _` o`nojno`mji\ \ @DP+ Hjn k\^d`io`n km`n`io\i
pijn b`ido\g`n dio`mijn ijmh\g`n) k`mj gjn `so`mijn nji _`
odkj a`h `idij+
à RÄ\n _` h\_pm\^dÇi _`g `nk`mh\ojujd_`+ Pm\n n\gdm _`g

K
o\i g\ cjmh ji\ \iodh Ñgg`md\i\ %=dRgD&) lp` di_p^` g\ m`bm`*
ndÇi kjm \kjkojndn _`g ^ji_p^oj _` dRgdegg`m %^ji_p^oj
Jl
k\m\h `nji~amd^j&+ H\n ^~gpg\n _` H`t_db) `nodh pg\_\n kjm g\
bji\_jomjkdi\ ^jmdÇid^\ cph\i\) n`^m`o\i o`nojno`mji\+
oÉ ]pgj n`hdiÄa`mj) `g `nk`mh \ojujd_` dih \_pmj ndbp` g\
ndbpd`io` n`^p`i^d\7
.+ PÉ]pgjn m`^ojn+ Oji pi\n `nomp^opm\n op]pg\m`n `nom`^c\n
m`q`nod_\n _` `kdo`gdj ^É]d^j ndhkg`+ H\n pidji`n c`mh~od^\n

/ . + PN = JOLK N PA U I = @ Q N = ? Eï J @AH AOLAN I = PK VK E@ A e 30.

booksmedicos.org
 n` gj^\gdu\i `i kjnd^dÇi \kd^\g) \ _da`m`i^d\ _` g\n pidji`n
c`mh~od^\n `iom` g\n ^~gpg\n _` O`mojgd) lp` nji ]\n\g`n+
/+ N`_ o`nod^pg\m+ An pi\ m`_ _` ^\i\g`n \i\nojh jn\_jn
m`q`nod_jn _` pi `kdo`gdj ^É]d^j ndhkg`+ Ai g\ k\m`_ `sdno`i
^~gpg\n h djd_`n t ad]mj]g\nojn+
0+ ? ji_p^odggjn `a`m`io`n+ ?ji`^o\i g\ m`_ o`nod^pg\m ^ji
g\ m`bdÇi did^d\g _`g `kd_Ä_dh j+ Ag m`q`nodh d`ioj `kdo`gd\g
^jmm`nkji_` \ ^~gpg\n kmdi^dk\g`n ^ji h d^mjq`ggjnd_\_`n %`i
gpb\m _` `no`m`j^dgdjn& t ^~gpg\n ^dgd\_\n) lp` k\mod^dk\i `i
`g om\inkjmo` _`g `nk`mh \ojujd_` dih Çqdg c\^d\ `g `kd_Ä_dh j+
Ag h\mb`i a`noji`\_j oÄkd^j _`g `kdo`gdj n` _`]` \ g\ `sdn*
o`i^d\ _` \bm`b\_jn _` `no\n _jn ^~gpg\n _` \gopm\ _dn*
odio\+
1+ Akd_Ä_dhj+ An pi ^ji_p^oj h pt ^jiojmi`\_j %1 *3 ^h
_` gjibdop_& ^ji om`n m`bdji`n \i\oÇhd^\n oÄkd^\n7 g\ ^\]`u\)
`g ^p`mkj t g\ ^jg\+ Ag `kdo`gdj _` m`q`nodh d`ioj `n n`p_j`n*
om\odad^\_j ^dgdi_md^j ^ji `no`m`j^dgdjn+ Ai g\ k\m`_ n` m`^j*
ij^` h Én^pgj gdnj+ Hjn _jn odkjn _` ^~gpg\n h}n dh kjmo\io`n
nji g\n ^~gpg\n kmdi^dk\g`n ^dgdi_md^\n) ^ji `no`m`j^dgdjn) t g\n
^~gpg\n ]\n\g`n) \nj^d\_\n \ g\ g}hdi\ ]\n\g+ ?ji am`^p`i^d\
n` d_`iodad^\i gdiaj^dojn diom\`kdo`gd\g`n+ H\ \gopm\ _` g\n ^~gp*
g\n kmdi^dk\g`n _dnh dipt` c\^d\ g\ ^jg\+ Ai ^jin`^p`i^d\) g\
gpu `n ^\_\ q`u h}n \i^c\+ Ag bmjnjm _` g\ ^\k\ hpn^pg\m
\ph `io\ c\^d\ g\ m`bdÇi _` g\ ^jg\ _`g `kd_Ä_dh j+
2+ ?ji_p^oj _`a`m`io`+ An pi op ]j h pn^pg\m _` 1 2 ^h
_` gjibdop_ lp` n` m`^jij^` `i `g ^jm_Çi `nk`mh}od^j+ Ag
^ji_p^oj _`a`m`io` `no} m`q`nod_j _` pi `kdo`gdj ^dgdi_md^j
n`p_j`nom\odad^\_j ^ji `no`m`j^dgdjn+ H\ ^\k\ _` h Én^pgj
gdnj ^jh km`i_` pi\ ^\k\ ^dm^pg\m dio`mh `_d\ mj_`\_\ _`
_jn ^\k\n gjibdop_di\g`n) pi\ dio`mi\ t jom\ `so`mi\+ Komjn
`g`h `iojn _`g ^jm_Çi `nk`mh }od^j nji `g h Én^pgj ^m`h}n*
o`m) g\n \mo`md\n %`nk`mh}od^\) ^m`h\no~md^\ t \mo`md\ _`g
^ji_p^oj _`a`m`io`&) g\n q`i\n _`g kg`sj k\h kdidajmh ` %`n
dh kjmo\io` lp` `g kg`sj k\h kdidajmh ` t g\ \mo`md\ `nk`m*
h}od^\ om\inad`m\i `g ^\gjm k\m\ ^jin`mq\m g\ o`h k`m\opm\
o`nod^pg\m /*0 Ö? kjm _`]\ej _` g\ ^jmkjm\g k\m\ lp` g\
`nk`mh\ojb`id\ n`\ ijmh \g& t gjn i`mqdjn+ Ag ^ji_p^oj
_`a`m`io` o`mh di\ `i pi `som`h j _dg\o\_j gg\h \_j \hkjgg\)
lp` m`^d]` `g ^ji_p^oj _` g\ q`nÄ^pg\ n`hdi\g k\m\ _\m gpb\m
\g ^ji_p^oj `t\^pg\_jm) lp` \om\qd`n\ g\ kmÇno\o\+
à Cg}i_pg\n \^^`njmd\n b`ido\g`n+ H\n bg}i_pg\n \^^`njmd\n
_`g \k\m\oj b`ido\g h\n^pgdij nji g\n q`nÄ^pg\n n`hdi\g`n)
g\ kmÇno\o\ t g\n bg}i_pg\n ]pg]jpm`om\g`n _` ?jrk`m+
?\_\ q`nÄ^pg\ n`hdi\g ^jh km`i_` om`n ^jh kji`io`n7
.& pi\ ^}knpg\ _` o`ed_j ^jiepiodqj `so`mi\8 / & pi\ ^\k\
_` h Én^pgj gdnj dio`mh `_d\) t 0 & pi\ ^\k\ hp^jn\ dio`mi\
h pt kg`b\_\) m`q`nod_\ _` `kdo`gdj _` ^É]d^j ndh kg` \ ^dgdi*
_md^j n`p_j`nom\odad^\_j \kjt\_j `i pi\ g}hdi\ kmjkd\+ >\ej
g\ diagp`i^d\ _` gjn \i_mÇb`ijn) `g `kdo`gdj n`h diÄa`mj \kjmo\
`g 4 - *5 2 " _`g gÄlpd_j \g^\gdij _`g `t\^pg\_j cph \ij+ Ai
`no` gÄlpd_j n` d_`iodad^\i kmjo`Äi\n ^j\bpg\io`n n`hdi\g`n)
amp^ojn\ t kmjno\bg\i_di\n+
H\ kmÇno\o\ `n pi\ bg}i_pg\ op]pgj\gq`jg\m ^jhkp`no\
%m\hdad^\_\&+ H\n bg}i_pg\n kmjno~od^\n n` _dqd_`i `i om`n
m`bdji`n7 .& uji\ ^`iom\g) ^ji bg}i_pg\n k`mdpm`om\g`n h p^j*
n\n8 / & uji\ _` om\ind^dÄi) ^ji bg}i_pg\n k`mdpm`om\g`n
np]hp^jn\n) t 0 & uji\ k`mda|md^\) ^ji pi\n bg}i_pg\n op]p*
gj\gq`jg\m`n m\hdad^\_\n) gg\h\_\n bg}i_pg\n kmdi^dk\g`n+ H\n
bg}i_pg\n `no}i m`q`nod_\n _` pi `kdo`gdj ^dgdi_md^j ndh kg` j
30/ E Ddnojgjb}\ t ]djgjb}\ ^`gpg\m+ Eiomj_p^^dÄi \ g\ \i\ojh }\ k\ojgÄbd^\
booksmedicos.org
n`p_j`nom\odad^\_j t `i g\ gpu n` j]n`mq\i ^p`mkjn \hdg}^`jn)
md^jn `i bgp^jkmjo`Äi\n+ Ag gÄlpd_j \g^\gdij kmj_p^d_j kjm g\
kmÇno\o\ ^jiod`i` ajna\o\n\ }^d_\ t \ioÄb`ij kmjno~od^j `nk`*
^Äad^j %LO=&+ H\ i\opm\g`u\ \g^\gdi\ _`g n`h `i i`pom\gdu\ `g
`iojmij }^d_j _` g\ q\bdi\ kmjqj^\_j kjm `g }^d_j g}^od^j _`
`no\ m`bdÇi+
Qi\ cdk`momjad\ ^jh ]di\_\ _` g\n bg}i_pg\n k`mdpm`om\g`n
np]h p^jn\n t hp^jn\n t _`g `nomjh \ lp` g\n mj_`\ kmj*
qj^\ g\ cdk`mkg\nd\ kmjno|od^\ ]`idbi\ %D L > &+ Ano\ `iod_\_
qd`i` _`o`mh di\_\ kjm a\^ojm`n _` ^m`^dh d`ioj ^ji \^^dÇi
hdoÇb`i\ lp` n` kmj_p^`i `i g\n ^~gpg\n `nomjh \g`n t
`kdo`gd\g`n bg\i_pg\m`n `nodh pg\_\n kjm g\ _dcd_mjo`nojno`*
mji\ %@ DP&+ H\ o`nojno`mji\ n` ^jiqd`mo` `i @DP kjm g\
`iudh\ 2jÄ*m`_p^o\n\+ Hjn \b`io`n lp` ]gjlp`\i `no\
`iudh\ t gjn \iod\i_mÇb`ijn n` podgdu\i ^jh j om\o\h d`ioj
ij lpdmÉmbd^j _` g\ DL>+ Ag ^{i^`m _` kmÄno\o\ n` _`]` \
g\ om\inajmh \^dÇi h\gdbi\ _` g\n bg}i_pg\n kmjno~od^\n _` g\
uji\ k`mda~md^\+ Ai gjn k\^d`io`n ^ji ^}i^`m g\n ^ji^`iom\*
^dji`n _` LO= `i n\ibm` `no}i `g`q\_\n+
H\n bg}i_pg\n ]pg]jpm`om\g`n n`^m`o\i pi h j^j gp]md^\io`
c\^d\ g\ pm`om\ k`id\i\+
à Qm`om\n h\n^pgdi\ t a`h `idi\+ H\ pm`om\ h\n^pgdi\ h d_`
pijn / - ^h t ^jh km`i_` om`n n`bh `iojn7 .& g\ pm`om\
kmjno~od^\) ^pt\ gpu m`^d]` `g gÄlpd_j om\inkjmo\_j kjm gjn
^ji_p^ojn `t\^pg\_jm`n t o\h ]d~i `g kmj_p^oj _` g\ kmÇn*
o\o\8 / & g\ pm`om\ h`h ]m\ijn\) t 0 & g\ pm`om\ k`id\i\) lp`
m`^d]` `g gÄlpd_j gp]md^\io` _` g\n bg}i_pg\n ]pg]jpm`om\g`n+
Ag `kdo`gdj _` g\ pm`om\ kmjno~od^\ `n om\ind^dji\g %pmjo`gdj&)
^ji q\md\^dji`n m`bdji\g`n+ Asdno`i `naÄio`m`n _` h Én^pgj
gdnj t `nomd\_j `i g\ pm`om\ h`h ]m\ijn\+ H\ pm`om\ a`h `idi\
`n h}n ^jmo\ %1 ^h & t `no} m`q`nod_\ _` pi `kdo`gdj om\ind*
^dji\g) o\h ]d~i ^ji q\md\^dji`n m`bdji\g`n+ H\ hp^jn\
^jiod`i` bg}i_pg\n hp^jn`^m`ojm\n) o`ed_j h pn^pg\m gdnj
dio`mij t o`ed_j h pn^pg\m `nomd\_j `so`mij+
à L`i`+ Ag k`i` `no} ^jinodopd_j kjm om`n `nomp^opm\n ^dgdi*
_md^\n7 pi k\m _` ^p`mkjn ^\q`mijnjn t pi Éid^j ^p`mkj
`nkjiejnj+ H\n om`n `nomp^opm\n ^dgdi_md^\n ^jiq`mb`i k\m\
ajmh \m `g ^p`mkj _`g k`i`+ H\ kpio\ _`g ^p`mkj `nkjiejnj
^jmm`nkji_` \g bg\i_`+ Ag o`ed_j `m~^odg ^jiod`i` `nk\^djn
q\n^pg\m`n _`ijh di\_jn ndipnjd_`n) lp` nji dmmdb\_jn kjm
n\ibm` \mo`md\g t _m`i\_jn kjm ^\i\g`n q`ijnjn+ @ pm\io` g\
`m`^^dÇi) g\ n\ibm` \mo`md\g gg`i\ `nojn ndipnjd_`n) \g h dnh j
od` h k j lp` n` ^jh kmdh `i gjn ^\i\g`n q`ijnjn \_t\^`io`n
t n` dh kd_` np _m`i\e`+
Ag Çsd_j iÄomd^j) kmj_p^d_j kjm g\n m\h\n _`g i`mqdj _jmn\g)
_dapi_` kjm g\n pidji`n ^jh pid^\io`n `iom` g\n ^~gpg\n
h pn^pg\m`n gdn\n lp` ^dm^pi_\i \g ndipnjd_`+ @`iomj _` g\n
^~gpg\n hpn^pg\m`n gdn\n) `g Çsd_j iÄomd^j \^odq\ g\ bp\idg\oj
^d^g\n\ k\m\ b`i`m\m h jijajna\oj _` bp\ijndi\ ^Ä^gd^j
%^C I L& \ k\modm _`g omdajna\oj _` bp\ijndi\ %CPL&+ Ag ^CIL
di_p^` g\ m`g\e\^dÇi _`g h Én^pgj gdnj \g n`^p`nom\m `g ^\g^dj
\ gjn gpb\m`n _` _`kÇndoj diom\^`gpg\m`n t g\ n\ibm` \mo`md\g
n` \^ph pg\ _`iomj _` gjn ndipnjd_`n _dno`i_d_jn) gj lp`
kmjqj^\ g\ `m`^^dÇi _`g k`i`+ H\ `iudh\ ajnaj_d`no`m\n\
_`bm\_\ `g ^CöRgL) kjm gj lp` o`mh di\ g\ `m`^^dÇi+ Ag ndg_`*
i\adgj) pi dicd]d_jm _` ajnaj_d`no`m\n\) `n podgdu\_j k\m\
km`q`idm pi\ _`bm\_\^dÇi m}kd_\ _`g ^CIL `i ^\njn _`
_dnapi^dÄi `m|^odg+