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达尔文终生疾病之谜

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Charles Darwin's five-year tour of the Southern hemisphere on the HMS Beagle let him see the natural world in a new light,

查尔斯·达尔文搭乘小猎犬号环游南半球的五年让他用一种新的眼光看待自然世界,
helping him develop his theory of evolution by natural selection.
帮助他形成了他的进化论理论。
But it didn't provide any insights into a much more personal mystery: what made him so ill.
但是却未能提供洞察一个更加私人秘密的视角:是什么让他如此病重。
Darwin spent his entire life searching for relief from an endless litany of recurring symptoms.
达尔文倾其一生寻求缓解循环病症的无尽祈祷。
And while his condition improved at least somewhat towards the end of his life, he never figured out what made him so sick so often.
虽然他的病情在生命后期有所缓解,但他从未弄清楚是什么让他经常重病。
That puzzle has fascinated scientists and doctors in the decades since.
在后来的几十年中,这个谜团一直让科学家和医生们为之着迷。
They've combed over the symptoms and have come up with more than 40 different diagnoses.
他们梳理了这些病症并得出四十多种不同的诊断结果。
And while there's still no consensus, there are a couple plausible answers, most reasonable of which suggest he got an unfortunate genetic hand dealt to him by his mother.
虽然并未达成一致结论,还有很多貌似合理的答案,其中最为合理一种是他从母亲身上遗传的基因导致了这一切。
Darwin kept extensive health journals, applying the same meticulous note-taking he used in science to his own health.
达尔文大量阅读健康杂志期刊,将他对待科学严谨的笔记方法也运用到了他自己的健康之中。
The detailed documentation of his symptoms has made diagnosing his condition a common challenge in the medical community.
他对自己症状的详细文献让诊断他的病情成为了医学家的共同挑战。
But Darwin suffered from such a wide range of problems that it seems almost impossible to pinpoint a single, root cause.
但是达尔文患有各种各样的问题,似乎不可能查到一个根本原因。
For example, he was said to have a "weak stomach" because he was so quick to puke.
例如,据说他胃不好,因为他经常呕吐。
And he had bouts of fatigue that went way beyond exhaustion—he'd spend days "most terribly knocked up," as he phrased it.
并且他的几次疲劳不仅是让他精疲力竭—正如他所写,这些天是最糟糕的筋疲力尽。
But at various times in his life, he also experienced headaches, severe skin conditions, chest pains, trembling and numbness in his hands,
但是在他一生中的不同时期,他也经历了头疼、严重的皮肤病、胸痛、手部颤抖和麻木、
dizziness, shivering, visual disturbances, backaches, psychological symptoms, and more.
头晕、发抖、视觉障碍、背疼、心理症状等。
One of the earliest guesses was that his famous voyage was to blame, as he may have contracted Chagas disease—a parasitic infection spread by bug bite.
最早期猜测之一是这一切都归咎与他著名的航行,因为他或许在此航行中感染了美洲锥虫病—通过虫咬传播的寄生虫病。
But the idea has been strongly rebutted because no one else on the HMS Beagle got it,
但是这种想法被强烈反驳,因为小猎犬号上没有其他人感染了这种疾病,
and Darwin didn't show the classic physical signs of disease, like an enlarged esophagus or colon, in any of the doctor examinations he received throughout his life.
而在任何医生对达尔文的检查中并没有表现出该疾病的典型生理指标,比如食管或结肠扩大。
Also, Darwin experienced some of his symptoms before he set sail.
同样,达尔文在航行前就出现了他的这些症状。
Other doctors have proposed that his troubles were psychosomatic: physical symptoms arising from mental illness.
其他医生提议他的问题是心病:由于精神疾病而导致的身体症状。
He did have anxiety and depression, and some of his episodes coincided with periods of stress.
他确实患有焦虑和抑郁以及一些与压力周期相符的一些症状。
But many didn't, and most experts say mental illness alone can't explain all of his symptoms, especially given the severity and sheer number of problems he had.
但大部分不相符,而且多数专家表示单靠精神疾病还无法解释他的所有症状,特别是考虑到他所患疾病的严重性和绝对数量。
One diagnosis that fits pretty well is a poorly understood condition called CVS, which stands for Cyclic Vomiting Syndrome.
有一种诊断和他的症状相当符合,但人类对这种疾病知之甚少,即CVS—周期性呕吐综合征。
This is exactly as unpleasant as it sounds: sufferers experience periodically recurring bouts of severe nausea and vomiting,
就如同它听起来的那样:经历周期性的严重恶心和呕吐,

达尔文终生疾病之谜

which is definitely something "weak stomached" Darwin was all too familiar with.

这也就是达尔文非常熟悉的“胃不好”。
CVS patients have a higher than normal chance of anxiety disorders and depression, migraines,
CVS病人患焦虑症、抑郁症、偏头痛
and certain nervous system disorders that might explain Darwin's mysterious episodes of numbness, partial paralysis, and distorted vision.
以及某种神经系统疾病的几率更高,这或许能解释达尔文麻木、部分麻痹以及斜视发作之谜。
They also tend to have severe motion sickness, which describes Darwin's experience on the Beagle to a tee.
他们还易患上严重的晕动病,这也恰到好处地描绘了达尔文在小猎犬号上的经历。
It's hard to believe the poor guy spent a year and a half of that five year voyage at sea.
很难相信这个可怜的家伙在五年的航行中在海上呆了一年半。
Another point in CVS's favor is the fact that patients often seek out water during an episode
CVS的另一个事实是病人们常在发病期间想要找水
either drinking it in excess or spending long periods of time in baths or showers.
不管是过度饮水还是长时间泡在浴缸里或淋浴。
Doctors aren't sure why this helps, but more than half of patients report it eases their symptoms.
医生们并不确定为什么水能有所帮助,但是大多半病人都称水能缓解他们的症状。
And Darwin, too, seemed relieved by water: he noted improvement when treated with a popular remedy at the time called the "water cure,"
达尔文似乎也是如此:他写道,当利用那时的一种流行治疗方法—“水治疗”后,症状有所缓解,
which involved cold foot baths, scrubbing with wet towels, and cold compresses.
这种方法包括冷水足浴、用湿毛巾擦洗以及冷敷。
The exact cause of Cyclic Vomiting Syndrome is unknown, but it has been linked to abnormalities in mitochondrial DNA
周期性呕吐综合征的确切起因未知,但是这和线粒体DNA中的异常情况有关
which would also explain why his doctors didn't diagnose it. Mitochondria produce the universal fuel of cells.
这也能解释为什么他的医生没有诊断出这种疾病。线粒体生产细胞的普通能量。
That means mitochondrial diseases can affect almost any organ in your body and cause an enormous array of symptoms.
这意味着线粒体疾病能够影响身体的几乎所有器官并导致一系列症状。
But the first mitochondrial disease wasn't identified until the 1950s, more than seven decades after Darwin's death,
但是第一种线粒体疾病直到1950年代才被确认,距离达尔文离世七十年之久,
so his doctors couldn't have suspected one might be to blame.
所以他的医生无法诊断出病因。
And there are unique features to these diseases make them really hard to diagnose without specific genetic tests.
还有一些独特特征让这些疾病在不借助特别基因检测的情况下无法被诊断出来。
You can't simply track them in families unless you know what you're looking for, for example, because they don't obey the classical rules of inheritance.
例如,你无法仅在家族中追踪疾病,除非你知道自己在找什么,因为它们并不遵循遗传的经典法则。
That's because mitochondria only come from your biological mother—they're passed down through eggs.
这是因为线粒体仅来源于生母—它们通过卵子遗传。
And they have their own genome which encodes for many of their essential parts, so abnormalities in mitochondrial DNA can cause these cellular powerhouses to falter.
并且它们有自己的基因组编植于许多基本部分,所以线粒体DNA中的异常情况会导致这些细胞发电装置的衰退。
But each cell in your body can have hundreds to thousands of them, some of which might be normal and some that could be abnormal.
但是你身体内的每个细胞中都包含成百上千个线粒体,其中一些可能是正常的,而有一些则是畸形的。
Since it's possible to have different ratios of sick and healthy mitochondria in different cells, the same disease can produce a wide range of symptoms in a single person.
由于不同细胞中可能患病和健康线粒体的几率不同,所以在一个人体内,同一种疾病会产生不同症状。
They can even present differently in identical twins, let alone different people.
它们甚至在同卵双胞胎中的表现症状也不同,更不用说不同人了。
If Darwin's doctors had known about these conditions, they might have looked to see if any of his family on his mother's side exhibited signs.
如果达尔文的医生了解这些症状,他们或许能查看达尔文母系家族是否表现有这些迹象。
Interestingly enough, Darwin's mother and her brother both also suffered from illnesses with long lists of symptoms.
有趣的是,达尔文的母亲和她的哥哥也患有表现出大量症状的疾病。
And his mother's youngest sister died when she was only eight from an illness that strongly resembles another mitochondrial disorder called MELAS syndrome,
并且他母亲最小的妹妹在八岁时死亡,死于一种和其他线粒体疾病—melas综合征非常相似的疾病,
which stands for 'mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes.'
这种综合征代表着‘线粒体脑肌病、乳酸酸中毒以及类似中风发作。’
If mitochondrial diseases did run in the family on his mother's side, it would make sense that Darwin could have inherited one.
如果线粒体疾病确实存在于他母亲的那一家族中,达尔文得到遗传也就说得通了。
And MELAS might fit the bill even better than CVS, because the stroke-like episodes in its name would explain the periodic episodes of partial paralysis, memory loss,
MELAS或许比CVS更符合他们的症状,因为类似中风发作这个名字本身就能解释达尔文在其五十多岁所开始经历的部分麻痹、失忆、
and difficulty or inability to speak that Darwin began to experience in his 50s.
以及说话困难或没有说话能力的周期性发作。
MELAS also causes a build-up of lactic acid in the bloodstream which can cause severe abdominal pain, vomiting, and fatigue, all of which Darwin frequently experienced.
MELAS同样会引起血流中乳酸的聚集,造成严重的腹痛、呕吐以及疲劳,这些达尔文都经常经历。
Of course, we may never really solve the mystery of Darwin's illness.
当然,我们可能永远无法解开达尔文疾病之谜。
And it may be that more than one condition was to blame, which would mean doctors are mistakenly shoehorning too many symptoms into one diagnosis.
或许导致这些症状的病因不止一种,这就意味着医生们错误地将多种症状塞入一种诊断之中。
The only way to know for sure if any of these hypotheses is right would be to exhume his body for tests—which seems a bit extreme.
证实这些假设的唯一办法就是从墓中挖出他的尸体进行检验—这样有点极端。
Thanks for watching this episode of SciShow, a Complexly production.
感谢收看本期科学秀,本期科学秀由Complexly出品。
If you want to learn more about Darwin's transformative theory and how he developed it, you might like the episodes on our sister channel, Crash Course, on evolution.
如果你想了解更多关于达尔文改造性理论的知识以及他是如何发展这种理论的,你或许会喜欢我们姐妹频道Crash Course地视频。

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array [ə'rei]

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n. 数组,(陈)排列,大批,一系列
vt.

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partial ['pɑ:ʃəl]

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adj. 部分的,偏袒的,偏爱的
n. 泛音

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consensus [kən'sensəs]

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n. 共识,一致,合意
n. [生理]交感

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recurring [ri'kə:riŋ]

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