次の2つの文章を読み、それぞれに続く設問に答えなさい。

(英文1)

If human eyesight had been better, we might never have experienced the first revolution, when we noticed the hidden wonders of life. Our poor eyesight inspired a simple piece of technology - the lens. Unexpectedly, this practical aid to our everyday activities spun off two types of scientific instrument: the telescope and the microscope. These opened up the vast reaches of the cosmos and the intricate small-scale world of living creatures.

As soon as we progress beyond the unaided human eye, with little more than a polished lump of glass to assist us, our simple, comfortable picture of the world changes. Through his telescope Galileo saw spots on the Sun, mountains on the Moon. phases of Venus, and four tiny specks of light passing to and fro across the orange disc of the planet Jupiter. He deduced-could scarcely fail to deduce, as soon as he put his mind to it-that the Sun and Moon are not unblemished spheres, Venus orbits the Sun, and the Earth is not a fixed center ( ア ) the rest of the universe revolves.

The religious authorities of the time, who considered themselves to be custodians of the truth, were aghast. Galileo managed to enforce the official view of truth, but at his trial for heresy in 1633 he was forced to deny his own deductions from the evidence that he had seen through his telescope. The authorities of the day did not dispute the evidence. They simply told Galileo to ignore it, and stop writing about lt. I'm inclined to believe that they acted like this not because they were religious, but because they were( イ ).

So Galileo recanted, though allegedly muttering under his breath (ウ) 'even so, it moves'. And the Earth continued to move round the Sun, whatever the Church believed and whatever Galileo was publicly obliged to assert. The scientific evidence eventually prevailed, but by the time Pope John Paul Ⅱ apologized for how Galileo had been treated, science had put men on the Moon.

If a humble telescope could cause such ructions, merely by revealing things that were there, what about the microscope? That opened up ( エ )-in particular, living creatures. The potential for heretical ideas was far greater than anything that astronomy could inspire. Yet curiously, the religious authorities viewed this even more revolutionary development with apparent equanimity, even though the new evidence now made available to the human eye would totally change our ideas about the world and our place in lt. I suspect that the authorities simply didn't grasp the microscope's potential. The wonders it revealed did not, initially, appear to conflict with Scripture. The Church, taking a positive religious message, believed the microscope was merely showing us the hidden marvels of God's creation. A pity they didn't think the same about Galileo.

In fact, the microscope was far from innocuous. It quickly revealed that our world is not what it seems. It does not function solely on the human level, it was not made for humans; everything that humans had been taking for granted about plants and animals was up for grabs, and for most of it was wrong. Even those things, like cats and cows and trees, that do seem to function on a human level...don't.

(ク) On the human level, a cow seems simple. You feed it grass, and it pays you back with milk. It's a trick whose secret is limited to cows and a few other mammals (most can't digest grass). You don't need to understand the details to exploit the process: it's a straightforward transformation from grass into milk, more like chemistry-or alchemy-than biology. It is, in its way, magic, but it's rational magic that works reliably. All you need is some grass, a cow and several generations of practical knowhow.

Seen through a microscope, though, it all gets more complicated. And the closer you look, the more complicated it gets. Milk is not a single substance, but a mixture of many. Grass is so complex that we still don't fully understand lt. A cow's complexity is even greater. In particular, a cow (plus a bull) can make a new generation of baby cows. This is a simple thing on a human level, but increasingly complex on a microscopic level.

(Adapted from Ian Stewart, The Mat11e, natics of Life, 2011.)

• (ア) Fill in the blank ( ア )：
  • (1) which
  • (2) in which
  • (3) from which
  • (4) around which
• (イ) Fill in the blank ( イ )：
  • (1) scientists
  • (2) scholars
  • (3) authorities
  • (4) debaters
• (ウ) In the phrase 'even so, it moves' what is meant by “it”?
  • (1) The Sun
  • (2) The Moon
  • (3) The Earth
  • (4) The universe
• (エ) Fill in the blank ( ェ )：
  • (1) the way to convince the religious authorities
  • (2) the internal world of very small things
  • (3) the vast reaches of the cosmos
  • (4) the medical treatment of human sight
• (オ) What can be inferred from the passage?
  • (1) Galileo agreed that the Church's judgment was correct.
  • (2) The Church should have given Galileo credit sooner.
  • (3) The religious authorities felt obliged to discover new versions of the truth
  • (4) The Church felt threatened by all types of scientific instruments.
• (力) According to the passage, the religious authorities viewed the microscope with equanimity because:
  • (1) the new evidence through the microscope would change our ideas about the world.
  • (2) the wonders the microscope revealed conflicted with Scripture.
  • (3) they believed the microscope's potential was far greater than the telescope's.
  • (4) they be「loved the microscope was showing us the hidden miracles by God.
• (キ) According to the passage, the microscope revealed that:
  • (1) our world functions on the human level.
  • (2) our world is not made for humans.
  • (3) things that seem to function on a human level do really function.
  • (4) everything that humans had understood about plants and animals was truthful.
• (ク) According to the passage, why does a cow seem simple on the human level?
  • (1) We can see a straightforward process of grass-feeding and milk payback.
  • (2) We can see the digestion of grass.
  • (3) We can understand the process of digesting grass.
  • (4) We can understand the magical transformation from grass into milk.
• (ケ) Which of the following is not true on a microscopic level?
  • (1) A bull is a really complex creature, needed for reproduction.
  • (2) Milk consists of many substances.
  • (3) We can completely understand grass if we look at it through a microscope.
  • (4) A cow's reproduction is a far more complex process.
• (コ) What is the main point that the author wants to convey?
  • (1) Sometimes quite simple technology can result in remarkable advancements of human understanding.
  • (2) The advancement of scientific discovery concurs with limitations in our daily life.
  • (3) There is adequate understanding of the world around us by both scientists and religious authorities.
  • (4) Using a telescope for astronomy is more advanced than using a microscope for biology.

(英文2)

That first night of internship showed me that I needed to think differently from how I had learned to think in medical school-indeed, differently from the way I had ever thought seriously in my life. This was despite my having met patients like Mr. Morgan before. During medical school we had studied what are called paper cases, patients in the form of written data. The attending physician would hand out a detailed description that would begin something like this:“A 66-year-old African-American retired postal worker with a history of poorly controlled hypertension presented to the hospital with the chief complaint of worsening chest pain over several weeks. Initial evaluation ruled out angina. On the third day of the hospital stay, he developed acute respiratory distress.” The attending would then give more details on Mr. Morgan-the range of his elevated blood pressure, the medications that failed to control it in the past-and lead us through a systematic analysis of the problem. First, the chief complaint, here acute shortness of breath. Second, the history of the present illness, ( サ ) having been ruled out. Third, the medical history, notably poorly controlled hypertension. Fourth, the physical examination.

Hands would shoot up in the classroom as students offered their ideas about what was wrong. Our mentor would take these hypotheses and write them on the board, creating a (シ)“differential diagnosis”, a laundry list of possible causes of sudden shortness of breath in a man with this medical history and these physical findings. From this differential diagnosis, he would point to the right answer and then enumerate the measures taken to restore respiratory and cardiac function until the patient was placed on heart-lung bypass in the OR.

In the last two years of medical school, when we saw patients on bedside rounds, the attending physician modeled a similar intellectual strategy for us. He would lead us through a calm, deliberate, and linear analysis of the clinical information and how to treat the malady.

As Robert Hamm of the Institute of Cognitive Science at the University of Colorado, Boulder, contends, the irony is that our mentor, the senior attending physician, does not think this way when he actually encounters a patient like William Morgan. At such moments, Hamm writes. it is not evident that any “reasoning” is being used at all. Studies show that while it usually takes twenty to thirty minutes in a didactic exercise for the senior doctor and students to arrive at a working diagnosis, an expert clinician typically forms a notion of what is wrong with the patient within twenty seconds. According to Hamm and other researchers on physician cognition, if I had asked the senior doctor what was going on in his head, he would have been hard-pressed to describe lt. It simply happened too fast.

Dr. Pat Croskerry, an emergency room doctor in Halifax, Nova Scotia, began his academic career as a developmental psychologist and now studies physician cognition. He explained to me that (セ) “flesh-and-blood decision-making” pivots on what is called pattern recognition. The key cues to a patient's problem - whether from the medical history, physical examination, x-ray studies, or laboratory tests - coalesce into a pattern that the physician identifies as a specific disease or condition. Pattern recognition, Croskerry told me, “reflects an immediacy of perception.” It occurs within seconds, largely without any conscious analysis; it draws most heavily on the doctor's visual appraisal of the patient. And it does not occur by a linear, step-by-step combining of cues. The mind acts like( ソ ), pulling in the cues from all directions.

(Adapted from Jerome Groopman, How Doctors Think, 2007.)

• (サ) Fill in the blank ( サ )：
  • (1) hypertension
  • (2) chest pain
  • (3) angina
  • (4) respiratory distress
• (シ) What is a “differential diagnosis”?
  • (1) a long list of physical examinations
  • (2) a long list of medications
  • (3) a long list of possible causes of an illness
  • (4) a long list of possible measures to be taken
• (ス) According to Robert Hamm, what does the senior attending physician do when he actually encounters a patient?
  • (1) He uses reasoning qui te carefully.
  • (2) He arrives at a working diagnosis in twenty to thirty minutes.
  • (3) He makes a linear analysis of the clinical information.
  • (4) He comes up with a working diagnosis within twenty seconds.
• (セ) According to Dr. Pat Croskerry, “flesh-and-blood decision-making” is：
  • (1) a specific disease
  • (2) a process of collecting the key cues to a patient's problem step by step
  • (3) a process which depends heavily on pattern recognition
  • (4) a pattern that occurs by a linear, step-by-step combining of cues
• (ソ) Fill in the blank ( ソ )：
  • (1) a magnet
  • (2) a disease
  • (3) a blood vessel
  • (4) a computer
• (タ) According to the passage which of the following is false?
  • (1) Attending physicians do not use linear analysis when meeting a patient.
  • (2) Flesh-and-blood decision-making is taught mainly in medical school.
  • (3) Research shows that physicians do not use didactic reasoning in the field.
  • (4) Pattern recognition is not a time consuming process.
• (チ) What can be inferred from the passage?
  • (1) Medical schooldoes not duplicate the internship experience.
  • (2) Internship is unnecessary for the medical student.
  • (3) Senior physicians and mentors are obliged to use differential diagnosis.
  • (4) Visual clues are the main trigger for expert clinicians to reach a diagnosis.
• (ツ) What is the main point that the author wants to convey?
  • (1) There are lessons learned in the classroom that are not replicated in the working environment.
  • (2) Differential diagnosis should be used both in the classroom and in the actual assessment of flesh-and-blood patients.
  • (3) An attending physician reasons in much the same way as any professional does.
  • (4) It is up to the intern to establish pattern recognition from an early stage of learning.
• (テ) According to the passage, what is the main reason for the difference in differential diagnosis and flesh-and-blood decision-making?
  • (1) The attending physician has an innate preference for one or the other.
  • (2) Time constraints require the physician to utilize pattern recognition.
  • (3) Intellectual reasoning occurs only after years of experience.
  • (4) Key clues to reach a proper diagnosis can only be accessed through reasoning.
• (ト) Choose a suitable title for the passage：
  • (1) Flesh-and-blood decision-making
  • (2) The last two years of medical school
  • (3) An immediacy of perception
  • (4) Emergcncy medicine