Abstract
Robert Koch early recognized that the postulates of causation he had included in 1882 in papers on the etiology of tuberculosis (Koch, 1882a,b; 1938) had their limitations. In a subsequent paper on bacteriological research presented at the International Medical Congress in Berlin (see Koch, 1890) he stated that while the bacteria of anthrax, tuberculosis, tetanus, and many animal diseases fully fulfilled his postulates, many others did not. These latter included the organisms of typhoid fever, diphtheria, leprosy, relapsing fever, and Asiatic cholera. The biggest problem was the failure to reproduce “the disease anew” in an experimental animal. He therefore felt that fulfillment of only the first two postulates was necessary to establish causation. Many other diseases have subsequently failed to fulfill the three postulates, or even two of them. In this chapter, I will discuss the limitations of the postulates from three standpoints: (1) those limitations that directly affected each of the three postulates, as stated in Rivers’s (1937) translation, (2) the effect of newer concepts of pathogenesis and epidemiology on the need to modify the postulates, and (3) the influence of new technological developments that permitted identification of new organisms that could not be grown in pure culture, even if one includes tissue cultures for viruses as the equivalent of standard culture methods for bacteria. A summary of the limitations of the postulates is given in Table 7.1 as derived from previous publications (Evans 1977, 1980).
Keywords
- Chronic Fatigue Syndrome
- Carrier State
- Typhoid Fever
- Hairy Cell Leukemia
- Infectious Mononucleosis
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
A modified version of this article has appeared in the Yale Journal of Biological Medicine (Evans, 1991b).
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Evans, A.S. (1993). Limitations of the Henle—Koch Postulates. In: Causation and Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3024-4_7
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