Iintlungu Ezingasayi Kuphinda Zibekho
IINTLUNGU eziya kupheliswa xa kuzalisekiswa idinga leBhayibhile iya kuba ziintlungu eziviwa ngenxa yokungafezeki komntu wokuqala. Ezi ntlungu ziquka ezo zibizwa ngokuba ziintlungu ezingapheliyo.
Endaweni yokuba zisebenze njengento yokukulumkisa ngesifo okanye ingozi okuyo, iintlungu ezingapheliyo ziye zafaniswa “ne-alarm esuka ikhale nje” engacimiyo. Zezi ntlungu ke ezibangela abo banazo bachithe amawaka ezigidi zeerandi minyaka le bezama ukufumana isiqabu, ibe ziyabungxwelerha ubomi bezigidi zabantu.
Ingcali yeentlungu uGqr. Richard A. Sternbach wabhala: “Ngokungafaniyo neentlungu zokwexeshana, iintlungu ezingapheliyo azilophawu lokuba unesigulo esithile; iintlungu ezingapheliyo azisosilumkiso.” IEmergency Medicine yakugxininisa oku ngokuthi: “Iintlungu ezingapheliyo ayikho tu injongo yazo.”
Ngaloo ndlela, kwiminyaka yakutshanje oogqirha abaninzi baye bazijonga iintlungu ezilolo hlobo njengezisisigulo sokwenene zizodwa nje. UGqr. John J. Bonica ucacisa athi kwiThe Management of Pain, incwadi yanamhlanje exubusha ngeentlungu: “Iintlungu zokwexeshana ziluphawu lokuba unesifo okanye wenzakele. Kwiintlungu ezingapheliyo iintlungu zizodwa zisisifo.”
Imigudu Yokuzama Ukuqonda Iintlungu
Iintlungu azikaqondwa kakuhle ncam. Iphephancwadi iAmerican Health lathi, “Umdla ongapheliyo wokuzama ukwazi oko zikuko iintlungu, uziqhekeze iintloko izazinzulu.” Kumashumi ambalwa eminyaka adluleyo, beziqikelela ukuba iintlungu ziluhlobo oluthile lweziva-mvo, ezifanayo nezokubona, ezokuva nezokuchukumisa, eziviwa yincam yomthambo-luvo okhethekileyo osesikhumbeni ize ithwalwe ngomnye umthambo-luvo isiwe engqondweni. Kodwa le ndlela ilula yokuchaza iintlungu kwafunyaniswa ukuba ayichananga. Njani?
Enye into eyabangela ukuba lo mbandela uqondwe ngokutsha luhlolisiso olwenziwa kwelinye ibhinqa eliselula elalingenazo iziva-mvo zokuva iintlungu. Emva kokufa kwalo ngowe-1955, ukuhlolisiswa kwengqondo yalo nenkqubo yalo yemithambo-luvo kwenza waqondwa ngokutsha unobangela weentlungu. Oogqirha “bakhangela imithambo-luvo,” yachaza njalo iThe Star Weekly Magazine, kaJulayi 30, 1960. “Ukuba lalingenayo, kwakuzakuthiwa yiloo nto eyabangela ukuba eli bhinqa liselula lingeva zintlungu. Kodwa ke yayikho yaye ibonakala ikwimeko entle.
“Kwakhona, oogqirha bahlola ii-fiber zemithambo-luvo ekwakucingelwa ukuba zizo ezidibanisa imithambo-luvo nengqondo. Hayi ke, apha babeqinisekile ukuba baya kusifumana isiphako. Kodwa babuya nemband’ esikhova. Ezo fiber zazikwimeko entle zonke, ngokwendlela ezazibonakala ngayo, ngaphandle kwezo zayekayo ukusebenza ngenxa yokwenzakala.
“Ekugqibeleni, kwahlolwa ingqondo yeli bhinqa liselula, kwakhona, abazange bafumane nasiphi na isiphako. Ngokolwazi nangokweengcamango ezikhoyo, eli bhinqa liselula belimele ukuba liyaziva iintlungu ngendlela eqhelekileyo, ukanti lona lalingeva nditsho nokunyunjazwa.” Noko ke, laliwuva umphunga esikhumbeni salo yaye lalikwazi ukwahlula ukuhlatywa ngumva kanotaka nencam kanotaka, nangona lalingeva zintlungu xa lihlatywa ngunotaka.
URonald Melzack, owathi ngeminyaka yee-1960 wancedisa ekuvelisweni kwengcamango yokuchaza iintlungu, unikela omnye umzekelo wendlela ezintsonkothe ngayo. Wachaza oku: “UNksk. Hull wayesoloko esalatha kunyawo lwakhe olwalungekho [olwanqunyulwayo], yaye ekhala ngeentlungu ezazitsho kube ngathi ufakwe amalahle phakathi kweenzwane.” Lo kaMelzack waxelela iphephancwadi iMaclean’s ngowe-1989 ukuba ‘wayesaphanda inkcazelo yoko akubiza ngokuba “sisihelegu” seentlungu.’ Ukongezelela, kukho into ebizwa ngokuba yimbulaphu, apho umntu asenokuba nengxaki kwelinye ilungu lomzimba kodwa eve iintlungu kwelinye.
Ingqondo Nomzimba Zibandakanyekile
Sithetha nje iintlungu sele zibizwa ngokuba “kukuthungelana komzimba nengqondo okuntsonkothileyo.” Kwincwadi yakhe yowe-1992 ethi Pain in America, uMary S. Sheridan uthi “ukuva iintlungu kuxhomekeke kakhulu engqondweni kangangokuba maxa wambi ingqondo isenokungayamkeli into yokuba zikho yaye ngamanye amaxesha iyazakha ize izigcine njengezikhoyo nasemva kokuba ukwenzakala kokwexeshana kuphelile.”
Ukutshintsha-tshintsha kweemvakalelo zikabani, ukuzikisa ingqondo nobuntu bukabani nokusabela kwakhe ngokukhawuleza kumacebiso, nakwezinye iinkalo zonke ezi zinto zibalulekile kwindlela umntu asabela ngayo kwiintlungu. Ingcali yeentlungu uGqr. Bonica yaphawula oku: “Ukoyika nexhala zibangela ubani asabele ngokubaxekileyo.” Ngaloo ndlela, ubani usenokufunda ukuzicingela iintlungu. UGqr. Wilbert Fordyce, ongunjingalwazi wezifundo zengqondo oyincutshe kwiingxaki zeentlungu, ucacisa oku:
“Ingongoma asikukuba iintlungu ziyinto yokwenene kusini na. Kakade zona ziyinto yokwenene. Ingongoma yeyokuba ngabaphi oothunywashe abaphambili abaziphembelelayo. Ukuba kanye nje ngaphambi kwesidlo ndithetha ngesonka esifakwe i-ham, uginya ingwiqi. Le nto yenzeka ngokwenene. Kodwa yenziwa kukuyilindela. Akukho sonka sifakwe i-ham phambi kwakho. Abantu bayakhawuleza ukusabela xa besenziwa balindele into ethile. Oko kuphembelela indlela abantu abazenza ngayo izinto, ukuginya ingwiqi, uxinzeleleko lwegazi, indlela okhawuleza ngayo umzimba ukucola ukudla, iintlungu nezinye izinto.”
Kanye njengokuba iimvakalelo nemo yengqondo yakho zinokuzenza qatha iintlungu, zinako nokuzenza zibe ngathi azikho okanye zizithomalalise. Qwalasela omnye umzekelo: Ugqirha wotyando lwemithambo-luvo wathi xa wayeselula wayethabatheke yenye intombazana ngoxa wayehleli nayo kudonga olunomkhenkce kangangokuba akazange ayive loo ngqele iqhaqhazelisa amazinyo okanye eve zintlungu kwiindawo zokuhlala. Ucacisa athi, “Ndaphantse ndomela apho. Simele ukuba sahlala apho kangangemizuzu engama-45, kodwa andizange ndive nento le.”
Mininzi imizekelo enjengalo. Abadlali bebhola ekhatywayo abazinikeleyo emdlalweni okanye amajoni aphakathi edabini basenokwenzakala ngokumasikizi sekunjalo bangeva zintlungu kakhulu okanye bangaziva kwaukuziva ngelo xesha. Umhloli welizwe odumileyo waseAfrika uDavid Livingstone wabalisa ngokuhlaselwa kwakhe yingonyama eyayimdlakaza “njengengqeqe idlakaza impuku. Ukothuka . . . kwabangela yangathi ndiyaphupha nto leyo eyabangela andeva zintlungu.”
Kuyaphawuleka ukuba abakhonzi bakaYehova uThixo, abalindela kuye ngokuzola bethembele yaye bayame ngaye ngokupheleleyo, nabo maxa wambi baye banamava okungeva zintlungu. Omnye umKristu owabethwayo wanikela le ngxelo: “Imangalisa ngenene into yokuba emva kwemivumbo embalwa, andizange ndiphinde ndiyive kwakhona. Kunoko, kwakungathi ndiyiva ngeendlebe, ingathi kubethwa igongqo kude.”—IAwake! kaFebruwari 22, 1994, iphepha 21.
Indlela Ezilungelelaniswa Ngayo Iziva-mvo Zeentlungu
Kwilinge lokucacisa iinkalo ezintsonkothileyo zeentlungu, ngowe-1965 unjingalwazi wezifundo ngengqondo, uRonald Melzack nonjingalwazi wezifundo ngamalungu omzimba, uPatrick Wall, bavela nengcamango eyanconywa ngokubanzi yesango eziphumela kulo iintlungu. Kuhlelo lowe-1990 lwencwadi kaGqr. Bonica ethetha ngeentlungu wathi le ngcamango “yayiyenye yezona zinto zibalulekileyo zakha zenziwa kuphando ngeentlungu nakwezonyango.”
Ngokwale ngcamango, ukuvuleka nokuvaleka kwale ndawo kuthiwa lisango ikumnqonqo maxa wambi kuvulela okanye kuvalele isigidimi seentlungu esiya engqondweni. Ukuba kukho ezinye izinto eziviwa ngumzimba ezingezontlungu ezixinileyo kweli sango, ngoko isigidimi seentlungu esiya engqondweni sisenokuthinteleka. Ngaloo ndlela, ngokomzekelo, iintlungu ziyathomalala xa umnwe otshe kancinane uwuhlikihla okanye uwuvuthulula, ekubeni kukho nezinye izigidimi ezithunyelwa kumnqonqo ziye kuxinanisana kwelaa sango nezigidimi zeentlungu.
Enye into eyafunyaniswa ngowe-1975 yokuba imizimba yethu ivelisa izithomalalisi-zintlungu zayo ezibizwa ngokuba ziiendorphin yanceda ngokubhekele phaya kolu phando lokufuna ukuqonda izinto ezintsonkothileyo zeentlungu. Ngokomzekelo, abanye abantu basenokuziva kancinane okanye bangaziva kwaphela iintlungu kuba imizimba yabo ivelisa iiendorphin ezibaxekileyo. Kwakhona iiendorphin zisenokusenza siqonde imfihlelo yokuba iintlungu zincitshiswe okanye zide zipheliswe ngeacupuncture, eyinkqubo yezamayeza apho kufakwa emzimbeni iinaliti ezibhitye okonwele. Ngokutsho kweengxelo zamangqina okuzibonela, utyando oluthile lwentliziyo luye lwenziwa ngoxa umguli ehleli, esezingqondweni, yaye ezonwabele nje kusetyenziswa kuphela iacupuncture njengesibulali-zintlungu! Kutheni bengeva zintlungu nje?
Bambi bakholelwa kwelokuba ezi naliti zenza umzimba ukhuphe iiendorphin eziziphelisayo iintlungu okwexeshana. Enye into esenokuba iyenzeka ikukuba iacupuncture ibulala iintlungu kuba iinaliti zikhupha iifiber zeziva-mvo ezithumela izigidimi engqondweni ngaphandle kwezi zeentlungu. Ezi zigidimi zixinanisana kwisango elikumnqonqo, zithintela izigidimi zeentlungu zingedluli ziye engqondweni, apho ziviwa khona iintlungu.
Le ngcamango yesango nesibakala sokuba umzimba unezibulali-zintlungu zawo, zisenokusenza siqonde isizathu sokuba imeko umntu akuyo, iingcinga neemvakalelo zichaphazele indlela aziva ngayo iintlungu. Ngaloo ndlela, ukothuka okwabangelwa kukuhlaselwa yingonyama kusenokuba kwenza umzimba walo kaLivingstone wakhupha iiendorphin zaza zaxinanisana nezigidimi zeentlungu kumnqonqo wakhe. Ngenxa yoko, akazange azive kangako iintlungu.
Ukanti, njengokuba kuboniswe ngaphambili, indlela ubani acinga ngayo navakalelwa ngayo inokuba nemiphumo eyahlukileyo. Iingcinezelo ezininzi zobomi banamhlanje zisenokuyandisa indlela ubani aziva ngayo iintlungu ngokuvelisa ixhala, uxinezeleko nokurhwaqela kwezihlunu.
Noko ke, okuvuyisayo kukuba, abo baneentlungu banezizathu zokuba nethemba. Oku kungenxa yokuba abaguli abaninzi ngoku bayangenelwa kwiindlela zonyango eziphuculiweyo. Oko kuphucula kuphumele ekuqondweni bhetele kwale nkxwaleko yoyikekayo. UGqr. Sridhar Vasudevan, ongumongameli weAmerican Academy of Pain Medicine, wacacisa wathi: “Ingcamango yokuba ngamanye amaxesha iintlungu zinokuba sisifo yenza iinguqulelo kunyango lweentlungu lweminyaka yee-1980.”
Zibekho njani iinguqulelo kunyango lweentlungu? Ziziphi iindlela zonyango ezingqineke ziphumelela?
[Umfanekiso okwiphepha 24]
I-“acupuncture” izinciphisa okanye iziphelisa njani iintlungu?
[Inkcazelo]
H. Armstrong Roberts