Ngubani owaphuhlisa idayi emfusa yegazi? UMalachowski, uRomanowsky, uGiemsa

Ieosin ibomvu. Imethylene blue izuba. Zixube zombini, uqabe lo mxube kumaleko wegazi owomileyo, yaye ezinye iindawo zalo maleko ziba mfusa.

Ayizizo zonke iindawo. Kwisampulu elungiselelwe kakuhle, iinucleus zeeseli ezimhlophe zegazi ziba bomvu-mfusa, yaye ngaphakathi kwisifunxi-gazi semalariya ichromatin iba kwaloo mbala, ngoxa iiseli ezibomvu ezisingqongileyo zihlala zipinki necytoplasm ihlala ingwevu-zuba. Ngumbala omfusa owenza ukuba iintlobo zeeseli zahluleke kwezinye.

Akukho bhotile kwezi zimbini iqulethe umbala omfusa. Lo mbala uvela kuphela xa imveliso ethile yokuqhekeka kwemethylene blue idibana neeosin kwisilayidi, yaye ngeminyaka yoo1880 neyoo1890 kwakungekho mntu wayesazi ukuba loo mveliso ikhona, singasathethi ke ngokuba yayiyintoni. Abantu ababefuna lo mbala babesebenza ngeedayi ezingacocekanga, umntu ngamnye eyedwa, bengenandlela ethembekileyo yokufumanisa ukuba yintoni equlethwe yibhotile emva kokuhlala kwayo eshelufini iinyanga ezimbini.

Yiyo loo nto umbuzo okwisihloko unempendulo engaphezu kwenye enokuxhaswa, nesizathu sokuba impendulo itshintshe ngo2011.

Izinto ezazibonakala zazitshintsha nomxube

Le dayi ayizange iyilwe ngexesha elinye. Yaphuhliswa ngokongezelelwa kwamanyathelo. Utshintsho ngalunye kumxube lwenza ukuba kubonakale kanye inkcukacha enye entsha, yaye ukulandelelana kwezo nkcukacha yeyona ndlela icacileyo yokuqonda le mbali.

Unyaka	Okwakusesityeni	Oko wawunokukubona
1865	Ipicric acid, idayi yokuqala eyenziwe ngokwenziwa eyasetyenziswa egazini, nguWilhelm Erb	Ipateni efana nelayisi ngaphakathi kwezinye iiseli ezibomvu.
1876	Imethylene blue, nguHeinrich Caro noAdolf von Baeyer eBASF	Iibacilli zesifo sephepha, xa yayisetyenziswa nguRobert Koch. Iiseli zegazi kumbala omnye ozuba.
1880	Imethylene blue kunye neacid fuchsin, idayi engathathi cala kaEhrlich	Iiseli ezibomvu neengqolowa zeeosinophil zibomvu, iinucleus zizuba ngokunzulu, icytoplasm yeelymphocyte izuba ngokukhanyayo, neengqolowa ezimfusa nzulu ezazifunxa zombini iidayi. Yiyo loo nto le seli ibizwa ngokuba yi-neutrophil. Ukubalwa kokuqala kweeseli ezimhlophe ngokohlobo lwazo.
1888	Imethylene blue kunye neeosin. UCzesław Chęciński	Isifunxi-gazi ngokwaso: iimilo ezizuba ezifana nentyatyambo yedaisy (Plasmodium malariae) neemilo ezifana nerhengqa (iigametocyte ze-P. falciparum). Hayi inucleus yaso.
1890	Imethylene blue engakumbi, utywala obuncinane, kunye nepotassium hydroxide. UAlbert Plehn	Uluhlu lwemibala olubanzi nolunzulu ngakumbi, kuquka iiseli ezibomvu neengqolowa zeeosinophil ezinombala werose. Yayisabomvu nozuba kuphela.
1890	Ieosin kunye nemethylene blue eyenziwe yaba yialkaline ngebhoraksi. UErnst Malachowski	Ichromatin ebomvu-mfusa ngaphakathi kwisifunxi-gazi, inucleus yahlulwa kwicytoplasm. Yenziwa ngenjongo, yaye ngokwengxelo yakhe iziphumo zazinokuphindwa.
1891	Ieosin kunye nemethylene blue evela kwibhotile eyayinokungunda neyayineenyanga ezingaphezu kwezimbini. UDmitri Romanowsky	Kwaloo mbala umfusa, kanye kuphela, ngendlela ababengenakuyiphinda abanye.
1898 ukuya ku1902	Idayi enemibala emininzi ekhutshwe ngechloroform (Nocht); imethanol (Jenner); ukunyibilikiswa kwakhona kwentlenge etywaleni (Leishman, Reuter, Wright); iidayi ezilinganiswe ngobungakanani ezineglycerol (Giemsa)	Umbala omfusa nanini na ufunwa, kwimveliso eyayiziphatha ngendlela efanayo nakwilabhoratri elandelayo. Inguqulelo kaJenner, engenayo idayi eyenziwe yanemibala emininzi, yayingavelisi mfusa.
1940 ukuya ku1943	ULillie, uRoe noWilcox bahlula amacandelo baza bawavavanya ngalinye lodwa	YiAzure B, hayi umxube, elicandelo elivelisa umbala omfusa.

Ipateni ekwikholam yokugqibela yeyona ibalulekileyo. Inkqubela nganye yandisa uluhlu lwemibala, yaye ukwanda ngakunye kwenza ukuba kubonakale olunye ulwakhiwo. Umbala omfusa awungomhombiso wale ndlela; nguwo umahluko phakathi kokubona ukuba isifunxi-gazi sikhona nokubona oko sakhiwe ngako. Indlela idayi ngokwayo eyasuka ngayo kumzi-mveliso wedayi weBASF yaya kwezonyango yimbali ende ngakumbi enamaxwebhu ayo. Ulandelelwano olupheleleyo olungentla, olunomthombo oxhasa inqaku ngalinye, lugcinwe njengolandelelwano lwexesha lwabafake igalelo olunamakhonkco emithombo.

Umzobo: kwaloo mixube mithandathu izotywe ukubonisa oko kwakusesityeni noko kwaphuma kuso. Izangqa zibonisa iidayi; iibhloko ezingaphantsi zibonisa imibala ezo dayi ezazinokuyivelisa kumaleko wegazi. Akukho mxube wangaphambi ko1890 ubonisa ibhloko ebomvu-mfusa, yaye akukho nowasemva kwakhe ongayibonisiyo.

Indoda eyasebenzisa ibhoraksi ngenjongo

UErnst Malachowski wayengugqirha eBreslau, ngoku ebizwa ngokuba yiWrocław, owachitha umsebenzi wakhe wobugqirha esebenza bucala nakwikliniki encinane awayeyiqhuba nogxa wakhe, esenza umsebenzi waselebhu ngexesha lakhe lokuphumla. Wazalelwa eStrzelno ngomhla we12 Matshi 1857, wafunda ubugqirha kwiYunivesithi yaseBreslau, waza wasebenza ukusuka ku1882 ukuya ku1887 njengomncedisi kwisebe lezonyango lwangaphakathi kwiSibhedlele iAll Saints, ngelo xesha esasisesesibini ngobukhulu eJamani.

Waqala ngo1888 ngedayi ephindwe kabini kaChęciński noPlehn. Kwisampulu eyalungiswa ngo1889, wabona ukuba ichromatin yenucleus yeplasmodium yayidayeka ngokwahlukileyo kwicytoplasm, waza wafumanisa ukuba akakwazi ukuphinda loo nto. Wazama ukwenza imethylene blue ibe neasidi, nto leyo eyenza izinto zaba mandundu. Wazama ukuyenza ibe yialkaline ngebhoraksi, nto leyo eyayisebenza ngalo lonke ixesha. Wabonisa le ndlela esidlangalaleni ngomhla we15 Juni 1890 waza wapapasha inkcazelo epheleleyo ngakumbi ngoAgasti 1891, kuquka umyalelo wokusebenzisa ibhoraksi. Waphawula ukuba ukudaya kwakuthatha iiyure ezingamashumi amabini anesine nokuba iziphumo zaziphindwa ngokulula.

Iiyure ezingamashumi amabini anesine lixesha elide kwilabhoratri yokuxilonga, yaye iphepha lakhe alizange ligxininise kumbala omfusa-bomvu wenucleus yesifunxi-gazi. Nokuba sasiyintoni isizathu, akukho mntu waqalisa ukwenza imethylene blue ibe yialkaline ngenjongo de uNocht waphinda wakwenza oko ngo1898. UMalachowski akazange aphinde abhale ngokudaya igazi.

Isizathu sokuba kwaziwe okuncinane ngaye de kwakutshanje sinxulumene noovimba bamaxwebhu, asiyomfihlakalo. Phantse akukho mkhondo wobomi bakhe owasindayo kuncwadi lwezonyango, yaye noko kwasindayo kwafika ngendlela enye. Intombi yakhe uMarie yemka eJamani yaya eLondon ngo1939, yasebenza kuMkhosi waseBritani, yaza yahlala eKhanada; ingqokelela yayo yamaxwebhu osapho yaphelela kwiLeo Baeck Institute eNew York. Umntakwabo uLeo wabulawa kwiMfazwe Yehlabathi Yokuqala. Udade wabo uEva wagxothwa eBreslau wasiwa kwinkampu yokudlula yaseIzbica ngoAprili 1942 yaye akazange abuye. Unina uHedwig wazibulala ngomhla we22 Aprili 1942 kunokuba alinde ukugxothwa okufanayo. UMalachowski wayesele esweleke ngo1934, ngaphambi kwazo zonke ezo ziganeko.

Imbali yosapho ephela ngolo hlobo yimbali yosapho eyekayo ukucatshulwa. Amaphepha amabini awabuyisela uMalachowski kwimbali yokuphuhliswa kwale dayi, omabini apapashwa ngo2011, adityaniswa kusetyenziswa amaxwebhu akwiindawo zokugcina ePoznań naseWrocław kunye namaxwebhu kaMarie aseNew York.

Ibhotile enokungunda nomRashiya onethamsanqa

UDmitri Romanowsky wafunda ubugqirha kwiMilitary Medical Academy eSt Petersburg waza wasebenza ngemalariya phantse kuwo wonke umsebenzi wakhe wobugqirha. Ngo1890 wapapasha indlela eyayiphantse ifane nekaChęciński ngokokubhaliweyo: imethylene blue engaguqulwanga kunye neeosin, kukho ieosin ethe chatha kancinane.

NgoSeptemba 1891 wapapasha indlela eyamenza waduma, yaye inkcukacha eyayibalulekile yayifihlakele phakathi kwemiyalelo. Ezona ziphumo zakhe zintle zazivela kumxube wemethylene blue owawugcinelwe ukusetyenziswa, umxube wemethylene blue owawumi iinyanga ezingaphezu kwezimbini ukhula ukungunda kuwo. Ukungunda nexesha owawumi ngalo kwakususe ngokuyinxenye amaqela emethyl kwidayi. URomanowsky wayengakwazi oko yaye engenakukulawula, yaye abanye abasebenzi abazama indlela yakhe babengenakuwufumana umbala omfusa. Ithisisi yakhe yayingeniswe eSt Petersburg ngoJuni 1891, yiyo loo nto inkcazelo eqhelekileyo ithatha u1891 njengonyaka wokufunyanwa kwayo.

Umboniso kaMalachowski wawungoJuni 1890, ngaphezu konyaka ngaphambili, yaye indlela yakhe yayisebenza ngenjongo.

Kutheni le ndlela yathiywa ngegama lendoda engafanelekanga

Ubungqina obuxhasa uMalachowski badityaniswa nguKristine Krafts, uErnst Hempelmann noBarbara Oleksyn, yaye busekelwe kwizinto ezine. Umhla womboniso wasesidlangalaleni, uJuni 1890 xa uthelekiswa noSeptemba 1891. Igama elithi ngenjongo xa lithelekiswa nelithi ngethamsanqa. Isibakala sokuba uMalachowski wapapasha indlela yakhe, ibhoraksi nayo yonke enye into, ngoxa ekaRomanowsky yayixhomekeke kwinto eguquguqukayo engalawulwayo. Nokuphawula ukuba inkcazelo yenucleus yeplasmodium, kunye nombala omfusa owayenza yabonakala, yaphantse yanyamalala kuncwadi kangangeminyaka esixhenxe, kuba kwakungekho mntu wayenokuphinda inguqulelo eyafunyanwa ngengozi.

Basithetha ngokungafihlisiyo isigqibo sabo. Kwiphepha elingobomi bakhe bakubiza ukunikwa komnye umntu uzuko ngokuba “kukugqwethwa okuhlazisayo”, yaye bacaphula uRalph Lillie, owabhala ngo1978 esithi “mhlawumbi sifanele silubize olu sapho lweedayi ngokuba ziidayi zikaMalachowski”.

Eli bango liyaphikiswa, njengoko edla ngokuphikiswa amabango okuba ngowokuqala, yaye kufanelekile ukuchaza indlela le mpikiswano emi ngayo kunokuyisombulula. Ingxoxo yokuba ngubani owayengowokuqala kufuneka ichaze ukuba yintoni eyafunyanwayo. Ukuba okufunyanweyo ngumbala omfusa, uMalachowski nguye onomboniso wangaphambili obhalwe kumaxwebhu. Ukuba okufunyanweyo yindlela epapashiweyo, omabini amadoda apapasha ngo1891 yaye indlela yathiywa ngoRomanowsky. Ukuba okufunyanweyo yingcaciso, akukho namnye kubo onokubanga uzuko, kuba akukho namnye owayesazi ukuba ukuvuthiswa kukususwa kwamaqela emethyl, yaye akukho namnye owayenokutsho ukuba kutheni lo mbala uvela. Le ngongoma yokugqibela yeyona ishiywa ziinkcazelo ezixhaphakileyo. Isithako esisebenzayo yayikukungcola okwakungekho mntu ukuchongileyo, yaye umntu wokuqala ukuvelisa lo mbala ngenjongo wakwenza oko esebenzisa iresiphi enokuphindwa esekelwe koko kubonwe kuvavanyo, kungekhona ekuqondeni oko kwenziwa yiresiphi.

Amaphepha amabini ka2011 yeyona ngxelo ipapashiweyo epheleleyo yobungqina obuxhasa uMalachowski, yaye omabini angafundwa simahla kwiPubMed: uphononongo olude kuPMID 21235291 nephepha elingobomi bakhe kuPMID 21660627. Ingxelo yePubMed yolu phononongo ikwadwelisa uluvo ngalo, olwapapashwa kwakulo jenali kamva ngaloo nyaka ku86(5):366, nto leyo esikhumbuza ngokufanelekileyo ukuba le ngxoxo yaphikiswa kumaphepha ashicilelweyo kwangoko emva kokuvela kwayo.

Le mpikiswano ayikokungavumelani ngekhemistri. Wonke umntu obandakanyekayo uyavumelana ngokuba yintoni umbala omfusa nangokuba ngawaphi amacandelo awuvelisayo. Ukungavumelani kumalunga nokuba ngubani owafika kuqala, nokuba ingozi engenakuphindwa nangubani na ibalwa na njengokufikelela kuloo nto.

Oko kongezwa ngabantu abafika kamva

Ukuba uMalachowski wavelisa umbala omfusa kuqala, kutheni le dayi ithwele amagama kaRomanowsky, uWright noGiemsa?

Kungenxa yokuba idayi esebenza kanye ezandleni zomntu oyiphuhlisileyo ayisosixhobo sekhemikhali esinokuthenjwa. Umsebenzi owalandelayo waguqula umxube ongalawulekiyo waba yinto enokusetyenziswa ligcisa kwelinye ilizwe ngoLwesibini.

UNocht wafikelela apho ngokuqiqa. Emva kokungaphumeleli ukufumana iziphumo ezithembekileyo kwidayi elula engathathi cala, wagqiba ekubeni umbala omfusa umele ukuba uvela kwinto ekwimethylene blue engeyomethylene blue, waza waqalisa ukuyikhangela. UUnna wayesele ephawule ukuba imixube yemethylene blue esele indala yayidaya iingqolowa zeeseli zemast zibe bomvu, waza wacebisa ukuba kwakusenziwa into entsha njengoko idayi ivuthiswa. UBernthsen wayebonisile ngo1885 ukuba iimeko zealkaline zisusa amaqela emethyl kwimethylene blue, nokuba ezi mveliso zezo ngoku sizibiza ngokuba ziiazure. UNocht wakhupha inxalenye esebenzayo ngechloroform yaye wayenokuyibiza kuphela ngokuba bubomvu obusuka kwimethylene blue, ubomvu obuvela kwimethylene blue; uMichaelis wayithiya ngokuba yiazure I ngo1901. UJenner wasombulula iingxaki zokulungiselela nokusebenzisa umxube. Ukunyibilikisa kwakhona intlenge yemethylene blue neeosin kwimethanol engenamanzi kwavelisa umxube omnye ozinzileyo owawuqinisa umaleko wegazi njengoko uwudaya, kwaza kwaphelisa ukuqiniswa ngobushushu. ULeishman noReuter badibanisa idayi eyenziwe yanemibala emininzi kunye nesinyibilikisi sotywala, baza bafumana uzinzo nombala omfusa ngaxeshanye. UWright watshintsha ukugcinwa komxube kangangeeyure ezilishumi elinesibini kwi65 °C nokuwuyeka ume iintsuku ezilishumi, wasebenzisa iyure enye kumphunga oqukuqelayo. UGiemsa wayeka ngokupheleleyo ukuxhomekeka kumxube ovuthiswe ngokungalawulekiyo, wasebenzisa izixa ezilinganiswe kakuhle zeedayi ezaziwayo ezineglycerol kwimethanol ukuze imveliso ikwazi ukumelana nobushushu beendawo ezishushu. Akazange apapashe indlela awayeyenza ngayo imethylene azure ecocekileyo. Wayithengisa kwilabhoratri kaGqirha Grübler eLeipzig, eyayithengisa njengeazure I yaye ibanga ukuba yinguqulelo yayo kuphela eyayiyidayi yokwenene kaGiemsa.

Kusaphikiswana ngokuba yayiyintoni kanye kanye loo azure. Abanye bathi yayiyimethylene blue nje eyenziwe yanemibala emininzi, abanye bathi yayityebe ngeAzure B. Impendulo yavela ngenxa yemfazwe. Xa iidayi zaseJamani zazingasafumaneki, iqela leUnited States Public Health Service, uRalph Lillie ekunye noMaurice Roe noAimee Wilcox, lafumanisa ukuba okona kudaya kulungileyo kwakuvela kumacandelo amathathu ahluliweyo: imethylene blue engaguqulwanga, imveliso yokuqhekeka kwayo esuswe amaqela emethyl eyiAzure B, kunye neeosin. IAzure B yathatha indawo yeazure I eyayingafumaneki, yaye loo macandelo mathathu asesisiseko sedayi esetyenziselwa ukuxilonga imalariya namhlanje.

Ikhemistri yendlela la macandelo mathathu asebenzisana ngayo kwisilayidi ngumbuzo owahlukileyo okwelinye iphepha. Iphepha leendima zeedayi nekhemistri yeedayi zohlobo lukaRomanowsky lichaza oko kwenziwa yiAzure B neeosin nganye nokuba kutheni xa zidibene zivelisa umbala ongenakuveliswa yenye yazo iyodwa. Iphepha lokusetyenziswa kwimicroscopy nakwilabhoratri lichaza icala lokusebenza: oko kuboniswa sisampulu ethile elungiselelweyo, nendlela yokugweba ukuba imveliso ethile iyayifanelekela na indlela oceba ukuyisebenzisa.

Inxalenye yale mbali esasebenzayo namhlanje

Enye inkcukacha kweli bali ayizange iyeke ukuba yinyani ngo1902. Kangangeminyaka emalunga namashumi amahlanu, elona candelo libalulekileyo ledayi eqhelekileyo yemalariya ehlabathini yayikukungcola okungenagama. Kwakukho ngengozi, ubungakanani bako babuhluka kwiibhotile, into okwakuyiyo yayiyimfihlelo yorhwebo kwinxalenye yelo xesha, yaye kwakuphikiswana ngomlinganiselo wako de kwaba yiminyaka yoo1940. Abantu ababesebenzisa le dayi babengengabo abangakhathaliyo. Babengenandlela yokwazi ukuba yintoni equlethwe yibhotile.

Inguqulelo yanamhlanje yale ngxaki inye yinkcazo yeemfuno echaza inxalenye kuphela yezinto ezikwimveliso. Ukuthobela iUSP yindlela yokufikelela kwelona qondo liphezulu lokucoceka linikezelwa yimarike, kuba ingumgangatho opheleleyo opapashiweyo kunokuba ibe ngumlinganiselo omnye: ukuchongwa kwento, ukucoceka, ukungcola kweorganic kuquka iidayi zeazure, izinyibilikisi ezishiyekileyo, ukungcola kwee-elementi, intsalela emva kokutshiswa, imida yeentsholongwane kunye neeendotoxin zebhaktheriya. IBlupreme ifumana imethylene blue yayo kumvelisi wamayeza ize ipapashe isatifikethi esipheleleyo sohlalutyo, ukuze umgca ngamnye kolo luhlu ube nokujongwa kunokuba kubangwe nje ukuba kuyathotyelwa. Isatifikethi esichaza iziphumo zovavanyo lweentsimbi ezinzima size sikubize oko ngokuthobela iUSP sifana namhlanje nebhotile ebhalwe “imethylene blue evuthisiweyo”: kusenokwenzeka ukuba sisixhobo sekhemikhali esihle, kodwa ileyibhile ayikuxeleli ukuba yintoni ekuso.