Special Section on Comorbidity: Introduction

In the mid-20th century, Rene Dubos criticized the biomedical community for what he called “The Doctrine of Singular Etiology”: a powerful and pervasive axiom that reduced the disease process to a single cause for a single magic bullet (1959). As an alternative, Dubos called for a more ecological approach to human disease that recognized multiple, interacting factors that could either increase or reduce the risk and severity of noncontagious as well as contagious diseases. Although Dubos's writings were (and continue to be) well received, his critique had little impact on the epistemology of biomedicine or public health at the time. This was partly because of rapid technological developments that diverted lay and professional attention away from socio–environmental determinants and partly because health professionals were only beginning to recognize the complexities of emerging chronic diseases. This article is protected by copyright. All rights reserved