Etiology

Etiology (alternatively aetiology, aitiology) is the study of causation, or origination. The word is derived from the Greek αἰτιολογία, aitiologia, "giving a reason for" (αἰτία, aitia, "cause"; and -λογία, -logia).[1]

The word is most commonly used in medical and philosophical theories, where it is used to refer to the study of why things occur, or even the reasons behind the way that things act, and is used in philosophy, physics, psychology, government, medicine, theology and biology in reference to the causes of various phenomena. An etiological myth is a myth intended to explain a name or create a mythic history for a place or family.

Contents

Medicine

In medicine in particular, the term refers to the causes of diseases or pathologies.[2] The first ideas about microorganisms were those of the Ancient Roman scholar Marcus Terentius Varro in a 1st century BC book titled On Agriculture.[3] Contemporary medieval thinking on the etiology of disease was influenced by Galen and Hippocrates.[4] Medieval European doctors generally held the view that disease was related to the air and adopted a miasmatic approach to disease etiology.[5] In The Canon of Medicine, Avicenna discovered that they are caused by contagion that can spread through bodily contact or through water and soil.[6] He also stated that bodily secretion is contaminated by foul foreign earthly bodies before being infected.[7]

Ibn Zuhr (Avenzoar) was the first physician to provide a scientific etiology for the inflammatory diseases of the ear, and the first to clearly discuss the causes of stridor.[8] Through his dissections, he proved that the skin disease scabies was caused by a parasite, a discovery which upset the Galenic theory of humorism, and he was able to successfully remove the parasite from a patient's body without any purging or bleeding.[9]

When the Black Death reached al-Andalus in the 14th century, Ibn Khatima proposed that infectious diseases are caused by microscopic particles which enter the human body. Another Andalusian physician, Ibn al-Khatib (1313–1374), wrote a treatise called On the Plague, stating that the contagion could spread via garments, vessels and earrings.[7]

Etiological discovery in medicine has a history in Robert Koch's demonstration that the tubercle bacillus (Mycobacterium tuberculosis complex) causes the disease tuberculosis, Bacillus anthracis causes anthrax, and Vibrio cholerae causes cholera. This line of thinking and evidence is summarized in Koch's postulates. But proof of causation in infectious diseases is limited to individual cases that provide experimental evidence of etiology.

In epidemiology, several lines of evidence together are required to infer causation. Sir Austin Bradford-Hill demonstrated a causal relationship between smoking and lung cancer, and summarized the line of reasoning in the epidemiological criteria for causation. Dr. Al Evans, a US epidemiologist, synthesized his predecessors' ideas in proposing the Unified Concept of Causation.

Further thinking in epidemiology was required to distinguish causation from association or statistical correlation. Events may occur together simply due to chance, bias or confounding, instead of one event being caused by the other. It is also important to know which event is the cause. Careful sampling and measurement are more important than sophisticated statistical analysis to determine causation. Experimental evidence involving interventions (providing or removing the supposed cause) gives the most compelling evidence of etiology.

Etiology is sometimes a part of a chain of causation. An etiological agent of disease may require an independent co-factor, and be subject to a promoter (increases expression) to cause disease. An example of all the above, which was recognized late, is that peptic ulcer disease may be induced by stress, requires the presence of acid secretion in the stomach, and has primary etiology in Helicobacter pylori infection. Many chronic diseases of unknown cause may be studied in this framework to explain multiple epidemiological associations or risk factors which may or may not be causally related, and to seek the actual etiology.

Some diseases, such as diabetes or hepatitis, are syndromically defined by their signs and symptoms, but include different conditions with different etiologies. Conversely, a single etiology, such as Epstein-Barr virus, may in different circumstances produce different diseases such as mononucleosis, nasopharyngeal carcinoma, or Burkitt's lymphoma.

Mythology

An etiological myth, or origin myth, is a myth intended to explain the origins of cult practices, natural phenomena, proper names and the like. For example, the name Delphi and its associated deity, Apollon Delphinios, are explained in the Homeric Hymn which tells of how Apollo carried Cretans over the sea in the shape of a dolphin (delphis) to make them his priests. While Delphi is actually related to the word delphus ("womb"), many etiological myths are similarly based on folk etymology (the term "Amazon", for example). In the Aeneid (published circa 17 BC), Vergil claims the descent of Augustus Caesar's Julian clan from the hero Aeneas through his son Ascanius, also called Iulus. The story of Prometheus' sacrifice-trick in Hesiod's Theogony relates how Prometheus tricked Zeus into choosing the bones and fat of the first sacrificial animal rather than the meat to justify why, after a sacrifice, the Greeks offered the bones wrapped in fat to the gods while keeping the meat for themselves.

See also

References

  1. ↑ Aetiology (2nd ed. ed.). Oxford University Press. 2002. ISBN 0195219422. 
  2. ↑ Greene J (1996). "The three C's of etiology". Wide Smiles. http://www.widesmiles.org/cleftlinks/WS-364.html. Retrieved 2007-08-20.  Discusses several examples of the medical usage of the term etiology in the context of cleft lips and explains methods used to study causation.
  3. ↑ Varro On Agriculture 1,xii Loeb
  4. ↑ Maimonides: an early but accurate view on the treatment of hemorrhoids -- Magrill and Sekaran 83 (979): 352 -- Postgraduate Medical Journal
  5. ↑ Case study: the history and ethics clean air
  6. ↑ George Sarton, Introduction to the History of Science.
    (cf. Dr. A. Zahoor and Dr. Z. Haq (1997), Quotations From Famous Historians of Science, Cyberistan.
  7. ↑ 7.0 7.1 Ibrahim B. Syed, Ph.D. (2002). "Islamic Medicine: 1000 years ahead of its times", Journal of the Islamic Medical Association 2, p. 2-9.
  8. ↑ Prof. Dr. Mostafa Shehata, "The Ear, Nose and Throat in Islamic Medicine", Journal of the International Society for the History of Islamic Medicine, 2003 (1): 2-5 [4].
  9. ↑ Islamic medicine, Hutchinson Encyclopedia.

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