Universal etiology, multifactorial diseases and the constitutive model of disease classification

Area of Science:

• Medical Philosophy
• Epidemiology
• History of Medicine

Background:

• Traditionally, infectious diseases are viewed as having a universal, monocausal etiology, while chronic diseases are considered multifactorial.
• This distinction is often attributed to the classification models used for each disease type.

Observation:

• The monocausal model, often associated with infectious diseases, is critically examined.
• Modern 'multifactorial diseases' are defined by a constitutive model, not a monocausal one.
• Closer analysis reveals that infectious diseases are also defined using the constitutive model.

Findings:

• Neither infectious nor chronic diseases are strictly defined by the monocausal model.
• Both disease categories are better understood through a constitutive disease model.
• Classification models alone do not explain the perceived difference in etiological universality.

Implications:

• The historical perception of universal etiology in infectious diseases stems from 19th-century germ theory.
• Re-evaluating disease classification models is crucial for understanding disease etiology.
• This perspective challenges traditional epidemiological frameworks for infectious and chronic diseases.