Amayeza Akutshanje—Yintoni Anokuyifeza?

UNINZI lwabantwana lufunda luselula: Ukuze banqothule iipesika emthini, bakhwela emagxeni eentanga zabo. Nakwezamayeza kwenzeka into efanayo. Abaphengululi bezamayeza baye bafikelela amanqwanqwa aphezulu enkqubela ngokukhwela emagxeni oogqirha abadumileyo bamandulo.

Phakathi kwezo ngcungela zonyango zangaphambili kwakukho amadoda adumileyo anjengooHippocrates noPasteur, kwakunye namadoda anjengoVesalius, noWilliam Morton—magama lawo angaqhelekanga kwabaninzi. La madoda abe naliphi igalelo kwezamayeza zakutshanje?

Mhlamnene ukunyanga kwakungabandakanyi inzululuwazi kodwa kwakuquka iinkolelo nezithethe zonqulo. Incwadi ethi The Epic of Medicine eyahlelwa nguGqr. Felix Marti-Ibañez ithi: “Xa besilwa nesifo . . . , abantu baseMesopotamiya babesebenzisa amayeza bedibanisa nonqulo, ekubeni babekholelwa ukuba isifo yayisisohlwayo soothixo.” Amayeza aseYiputa awalandela kungekudala, ngokufanayo ayesekelwe elunqulweni. Ngenxa yoko, ukususela ekuqaleni, abo babenyanga babejongwa njengabantu bonqulo.

Kwincwadi yakhe ethi The Clay Pedestal, uGqr. Thomas A. Preston uthi: “Iinkolelo ezininzi zabantu bamandulo ziye zanegalelo kwezamayeza nto leyo esekho nanamhlanje. Enye yezo nkolelo yayikukuba isifo singaphaya kwamandla omguli, yaye kuphela kwakufuneka ugqirha abe namandla omlingo ukuze akwazi ukuphilisa umguli.”

Ukubekwa Kwesiseko

Noko ke, ekuhambeni kwexesha, ezonyango zaya zisondela ngakwinzululwazi. Oyena wayehamba phambili ekusebenziseni inzululwazi yezonyango yayinguHippocrates. Wazalwa malunga nowama-460 B.C.E. kwisiqithi saseGrisi iKos yaye abaninzi bamjonga njengomseki wezamayeza eNtshona. UHippocrates wabeka isiseko esisengqiqweni kwezamayeza. Wayikhaba ngaw’ omane ingcamango yokuba isifo sisohlwayo esivela koothixo, esithi sasibangelwa yimvelo. Ngokomzekelo, kudala kwathiwa isathuthwane sisifo esingcwele ngenxa yenkolelo yokuba sinyangwa ngoothixo kuphela. Kodwa uHippocrates wabhala wathi: “Ngokuphathelele isifo ekuthiwa siNgcwele: kum sibonakala singesosabuthixo konke konke yaye singekho ngcwele kunazo naziphi ezinye izifo, kodwa sinoonobangela bemvelo.” Kwakhona uHippocrates waba ngugqirha wokuqala odumileyo owafumanisa iimpawu zezifo ezahlukeneyo waza wagcina iingxelo zazo esenzela ixesha elizayo.

Kwiinkulungwane kamva, uGalen, ugqirha omgumGrike owazalwa ngowama-129 C.E., naye wenza uphando lwenzululwazi. Ngokusekelwe kumalungu abantu nawezilwanyana, uGalen wavelisa incwadi echaza amalungu eyasetyenziswa ngoogqirha kangangeenkulungwane eziliqela! UAndreas Vesalius, owazalelwa eBrussels ngowe-1514, wabhala incwadi ethi On the Structure of the Human Body. Ayizange ithandwe, ekubeni yayiphikise iingcamango ezininzi zikaGalen, kodwa yabeka isiseko sendlela achazwa ngayo amalungu omzimba namhlanje. Ngokutsho kwencwadi ethi Die Grossen (Abongamileyo), uVesalius waba “phakathi kwabona baphengululi babalaseleyo kubo bonke abantu nakulo naliphi na ixesha.”

Iingcamango zikaGalen eziphathelele intliziyo nokujikeleza kwegazi nazo zaphelelwa ekuhambeni kwexesha.a Ugqirha oliNgesi uWilliam Harvey wachitha iminyaka ehlolisisa amalungu ezilwanyana neentaka. Wahlolisisa ukusebenza kwemibhobho evulela igazi entliziyweni, walinganisa umkhamo wegazi kwigumbi ngalinye lentliziyo, waza waqikelela umkhamo wegazi elisemzimbeni. UHarvey wapapasha konke awakufumanisayo ngowe-1628 kwincwadi ethi On the Motion of the Heart and Blood in Animals. Wagxijwa, wachaswa, wahlaselwa waza wathukwa. Kodwa incwadi yakhe yeza neenguqulelo kwezamayeza—wafumanisa ukuba igazi lijikeleza njani emzimbeni!

Utyando Luqalwe Ngabachebi Beenwele

Kuye kwenziwa uphuculo gqitha kubuchule bokutyanda. Ebudeni bamaXesha Aphakathi, utyando lwalusenziwa ngabachebi beenwele. Abanye bathi utyando lwakutshanje lwaqalwa yindoda engumFrentshi eyayiphila ngenkulungwane ye-16 uAmbroise Paré—eyayiququzelela utyando ikwasebenzela ookumkani abane baseFransi njengomchebi weenwele. UParé wenza nezixhobo eziliqela zokutyanda.

Enye ingxaki enkulu abatyandi ababesenayo kwinkulungwane ye-19 yayikukungakwazi ukudoma iintlungu zotyando. Kodwa ngowe-1846 ugqirha wamazinyo ekuthiwa nguWilliam Morton wahlahla indlela ekusetyenzisweni kweendlela zokuphelisa iintlungu ebudeni botyando.b

Ngowe-1895, ngoxa yayisenza ulingelo embaneni, ingcali yemichiza yaseJamani uWilhelm Röntgen yabona imitha idlula enyameni kuphela kungekhona emathanjeni. Akazange ayazi imvelaphi yale mitha, ngoko wayibiza ngokuba yiX-reyi, gama elo elisasetyenziswa nangoku ngabo bantetho isisiNgesi. (amaJamani athi yiRöntgenstrahlen.) Ngokutsho kwencwadi ethi Die Großen Deutschen (AmaJamani Abalaseleyo), uRöntgen wathi kumfazi wakhe: “Abantu baza kuthi: ‘URöntgen uphambene.’” Abanye abantu batsho. Kodwa oko wakufumanisayo kwaba negalelo kwezotyando. Ngoku oogqirha botyando bayakwazi ukujonga ngaphakathi emzimbeni ngaphandle kokuwuvula ngokuwusika.

Ukoyisa Izifo

Ukutyhubela iminyaka izifo ezasulelayo njengengqakaqha ziye ngokuphindaphindiweyo zabangela oobhubhane, iintlungu nokufa. UAr-Rāzī, indoda yasePersi eyayiphila ngenkulungwane yesithoba eyayigqalwa ngabanye abantu njengogqirha ohamba yedwa kumaSilamsi elo xesha, wanikela inkcazelo yokuqala echanileyo ngokwezamayeza yengqakaqha. Kodwa kwathabatha iinkulungwane emva koko ngaphambi kokuba ugqirha waseBritani ogama linguEdward Jenner afumane indlela yokuyinyanga. UJenner wafumanisa ukuba xa umntu enengqakaqha efumaneka ezinkomeni—sifo eso esingenabungozi—ukhuselekile kwingqakaqha. Ngokusekelwe koku, uJenner wasebenzisa izicwili zenyama ezinengqakaqha esezinkomeni ukuze enze isitofu sokulwa nengqakaqha. Ngelo xesha kwakungowe-1796. Njengabanye abaqalisa izinto ezintsha ababengaphambi kwakhe, uJenner wagxijwa waza wachaswa. Kodwa ukufumanisa kwakhe inkqubo yokutofa ekugqibeleni kwakhokelela ekuphelisweni kwesi sifo kwaza kwabangela ukuba kubekho amayeza amatsha okulwa nesi sifo.

Indoda engumFrentshi uLouis Pasteur wasebenzisa isitofu sokulwa nomgada neanthrax. Kwakhona wangqina ukuba iintsholongwane zinendima ephambili ekubangeleni isifo. Ngowe-1882, uRobert Koch wafumanisa intsholongwane ebangela isifo sephepha, eyachazwa ngomnye umbhali-mbali “njengoyena mbulali uphambili ngenkulungwane yeshumi elinesithoba.” Malunga nonyaka emva koko, uKoch wafumanisa intsholongwane ebangela ikholera. Iphephancwadi iLife lithi: “Umsebenzi kaPasteur noKoch wakhokelela kwinzululwazi yezinto ezingenakubonwa ngeliso lenyama waza wakhokelela nasekuhambeleni phambili kwezogonyo, iinkqubo zogutyulo nempilo, nto leyo eye yanegalelo ekwandiseni ubomi babantu kunayo nayiphi na inkqubela yenzululwazi yeminyaka eli-1 000 eyadlulayo.”

Ezamayeza Ngenkulugwane Yama-20

Ekuqaleni kwenkulungwane yama-20, ezamayeza zazikhwele emagxeni aba gqirha nabanye ke abakrelekrele. Ukususela ngelo xesha, kuye kwenziwa inkqubela ekhawulezileyo kwezamayeza—iyeza lesifo seswekile, umchiza wokunyanga umhlaza, ukunyangwa kwencidi yamadlala, amayeza okubulala iintsholongwane ukuze kuliwe nesifo sephepha, iyeza lokunyanga iindidi ezithile zesifo seengcongconi, nokucocwa kwegazi xa kunyangwa izintso, kwakunye notyando lwentliziyo nokufakelwa kwamalungu, njalo njalo.

Kodwa njengoko siqalisa inkulungwane yama-21, zimi phi ezamayeza ekuqinisekiseni “umlinganiselo owamkelekileyo wempilo yabo bonke abantu behlabathi”?

Ngaba Olo Lusukelo Olungenakufikeleleka?

Abantwana baye bafumanise ukuba ukukhwela emagxeni oogxa babo akubenzi bazifumane zonke iipesika. Ezona pesika zivuzis’ izinkcwe zidla ngokuba phezulu kakhulu emthini, kwindawo engafikelelekiyo. Ngendlela efanayo, ezamayeza ziye zahambela phambili, zisenza inkqubela engakumbi. Kanti olona sukelo lufunwa ngumntu wonke—impilo entle kubantu bonke—alukafumaneki.

Ngenxa yoko, ngoxa iKomishoni yaseYurophu eyayibanjwe ngowe-1998 yanikela ingxelo yokuba “abantu baseYurophu abazange banandiphe ubomi obude nobunempilo,” yongezelela isithi: “Umntu omnye kwabahlanu uya kufa ngaphambi kwexesha engekayidibanisi iminyaka engama-65. Abamalunga nama-40% kwaba baya kubulawa ngumhlaza, baze abangama-30% babulawe zizifo zentliziyo . . . Abantu bafanele bafumane ukhuseleko olusemgangathweni nxamnye nezi zinto zisongela ubomi.”

Iphephancwadi laseJamani lezempilo iGesundheit ngoNovemba 1998 lanikela ingxelo yokuba izifo ezasulelayo ezinjengekholera nesifo sephepha ziya zibasongela abantu. Ngoba? Amayeza okubulala iintsholongwane “akasebenzi. Iintsholongwane ezingakumbi ziyawaxhathisa amayeza aqhelekileyo; enyanisweni ezininzi zixhathisa amayeza amaninzi.” Izifo ezazikho ngaphambili asikuba ziyabuya kuphela kodwa kuvela nezitsha ezinjengoGawulayo. Impapasho ethetha ngamayeza yaseJamani iStatistics ’97 isikhumbuza oku: “Malunga nesibini kwisithathu sazo zonke izigulo ezaziwayo—ezimalunga nama-20 000—okwangoku ayikho indlela yokuzinyanga.”

Ngaba Unyango Lwemizila Yemfuza Lunento Oluyenzayo?

Kuyavunywa ukuba kumana kuvela unyango olutsha. Ngokomzekelo, abaninzi bavakalelwa kukuba, unyango lwemizila yemfuza lunokukhokelela kwimpilo ebhetele. Emva kohlolisiso olwenziwa eUnited States ngowe-1990 ngoogqirha abafana noGqr. W. French Anderson, unyango lwemizila yemfuza lwachazwa “njengolona phando lubangela umdla kwezamayeza.” Incwadi ethi Heilen mit Genen (Ukunyanga Ngemizila Yemfuza) ithi unyango lwemizila yemfuza lunokubangela ukuba “inzululwazi yezamayeza ihambele phambili. Ubukhulu becala kunjalo oko ngonyango lwezigulo ezingekanyangwa ukuza kuthi ga ngoku.”

Izazinzulu zilindele ukuba ekuhambeni kwexesha zikwazi ukunyanga izifo ezikwimizila yemfuza ngokutofela imizila yemfuza engenasifo kubaguli. Kwaneeseli eziyingozi, njengeeseli zomhlaza, mhlawumbi ziya kwenziwa ukuba zizibulale ngokwazo. Sele kuhlolwa imizila yemfuza ukuze kubonwe izifo umntu asenokuba nazo. Abanye bathi iipharmacogenomics—amayeza afanele imizila yemfuza yomguli lowo—kuza kulandeliswa ngazo. Omnye umphengululi odumileyo uthi ngenye imini oogqirha baya kukwazi “ukufumanisa izigulo zabantu baze babanyange ngomcu wemolekyuli ofanelekileyo.”

Noko ke, asinguye wonke umntu oqinisekileyo ukuba unyango lwemizila yemfuza ‘luya kwenza imimangaliso’ kwikamva. Enyanisweni ngokutsho kohlolisiso oluye lwenziwa, abantu basenokungafuni ukuba kucukucezwe imizila yabo yemfuza. Kanti abanye boyikela ukuba unyango lwemizila yemfuza lusenokuphazamisana nemvelo ngendlela eya kubangela ingozi.

Kuya kubonakala ngokuhamba kwexesha ukuba unyango lwemizila yemfuza okanye ezinye iindlela ezihambele phambili zonyango ziya kuzizalisekisa izithembiso ezikhulu ezenziwayo. Noko ke, zikho izizathu zokungabi nathemba ngokungeyomfuneko. Incwadi ethi The Clay Pedestal, ithi xa ithetha ngomjikelo oqheleke gqitha: “Kufika unyango olutsha, luthathelwe phezulu kwiintlanganiso zamaziko ezamayeza nakoolindixesha abaziwayo. Abo luvele nabo bathathelwa phezulu, namaziko eendaba ayakuncoma oku kuhambela phambili. Emva kolonwabo namaxwebhu ancoma olu nyango lumangalisayo, kuqalisa ukunganeliseki, okuqhubeka kangangeenyanga ukusa kumashumi eminyaka. Emva koko kufunyaniswa unyango olutsha yaye ngesiquphe, luthabathela indawo olo lwangaphambili, ngoku olusele lugqalwa njengolungasebenziyo.” Enyanisweni, uninzi lonyango oluye lwayekwa luninzi loogqirha njengolungasasebenziyo belusandula ukuba lunyango olwamkelekileyo.

Nangona oogqirha namhlanje bengasagqalwa njengabanento yokwenza nonqulo njengabo babenyanga kumaxesha amandulo, abanye abantu banotyekelo lokuthi oogqirha banamandla afana nawoothixo, nawokucingela ukuba inzululwazi inokunyanga zonke izigulo zabantu. Noko ke, okulusizi kukuba oko akunjalo. Kwincwadi yakhe ethi How and Why We Age, uGqr. Leonard Hayflick uthi: “Ngowe-1900, ama-75 ekhulwini abantu baseUnited States bafa ngaphambi kokufikelela iminyaka engamashumi amathandathu anesihlanu ubudala. Namhlanje izinto zitshintshile kuloo nto: bamalunga nama-70 ekhulwini abantu abafa emva kokufikelela iminyaka engamashumi amathandathu anesihlanu ubudala.” Yintoni le yandisa ixesha lokuphila kangaka? UHayflick uthi oku “kwabangelwa kakhulu kukuthotywa kokufa kweemveku.” Ngoku makhe sithi inzululwazi yezamayeza ibinokuphelisa oonobangela abayintloko bokufa kwabantu abasele bekhulile—isifo sentliziyo, umhlaza, nokufa kwamalungu. Ngaba loo nto ibiya kuthetha ukuba abantu abasayi kufa? Kungangenkankulu. UGqr. Hayflick uthi nangelo xesha, “abantu abaninzi bebeya kuphila de babe nekhulu leminyaka ubudala.” Wongezelela ngelithi: “Nabantu abanekhulu leminyaka basaya kufa. Baya kubulawa yintoni? Baya kuqhubeka besiba buthathaka de bonganyelwe kukufa.”

Phezu kwayo nje imigudu emihle yenzululwazi yezamayeza, ukupheliswa kokufa kusengaphaya kwamandla ezamayeza. Kutheni kunjalo nje? Yaye ngaba usukelo lwempilo esemgangathweni lusengaphaya kwento enokufikelelwa?

[Imibhalo esemazantsi]

[Amagama acatshulweyo akwiphepha 4]

“Iinkolelo ezininzi zabantu bamandulo ziye zanegalelo kwezamayeza nto leyo esekho unanamhlanje.”—The Clay Pedestal

[Imifanekiso ekwiphepha 4, 5]

UHippocrates, uGalen, noVesalius babeka isiseko sezamayeza zanamhlanje

[Inkcazelo]

Kos Island, Greece

Courtesy National Library of Medicine

Woodcut by Jan Steven von Kalkar of A. Vesalius, taken from Meyer’s Encyclopedic Lexicon

[Imifanekiso ekwiphepha 6]

UAmbroise Paré wayeququzelela utyando esebenzela ookumkani abane baseFransi

Ugqirha wasePersi uAr-Rāzī (ekhohlo), nogqirha waseBritani uEdward Jenner (ekunene)

[Inkcazelo]

Paré and Ar-Rāzī: Courtesy National Library of Medicine

From the book Great Men and Famous Women

[Umfanekiso okwiphepha 7]

Indoda engumFrentshi uLouis Pasteur wafumanisa ukuba iintsholongwane zibangela izifo

[Inkcazelo]

© Institut Pasteur

[Imifanekiso ekwiphepha 8]

Kwanokuba oonobangela abayintloko bokufa banokupheliswa, ukwaluphala kusaya kuba ngunobangela wokufa