Q. Sir, can you tell me one company who has stood up and said -- besides Liggett -- one company that has stood up and said, "Smoking causes lung cancer?" Name me one.
A. Mr. Ciresi, they're not going to say it causes it because that implies a universal cause-and-effect relationship, and that simply does not exist.
Q. Sir --
A. If you say tuberculosis is caused by the tubercle Bacillus and we can consistently identify the tubercle Bacillus in the diseased tissue, then that's one-on-one. We know it is -- the tubercle Bacillus is the cause of tuberculosis and it is replicated time after time. But not every smoker has lung cancer and many people who don't smoke have lung cancer, so there are a lot of enigmas, mysteries that still surround the whole issue. And to say smoking causes lung cancer without defining the word "cause" puts you in serious jeopardy.
Q. Sir, can you name one company who has stood up and said -- besides Liggett -- "Smoking causes lung cancer?"
A. No, sir.
Q. Can you --
A. And I doubt they ever would say it in that -- in those terms because that simply is inaccurate.
Q. Now you mentioned tuberculosis, didn't you?
A. I did.
Q. And you said something about a virus that causes tuberculosis?
A. No, sir, I did not.
Q. What -- what did you say?
A. I said the tubercle Bacillus.
Q. The tubercle Bacillus. Is that a parasite?
A. Is that what?
Q. Is that a parasite?
A. No, sir.
Q. What is it?
A. It's a bacterium.
Q. It's a bacterium.
So the tubercle Bacillus causes tuberculosis in every case; correct?
A. If the patient has tuberculosis, it is caused by the tubercle Bacillus universally.
Q. Now what you're using there is the Jacob Henle and the Robert Koch postulates; aren't you?
A. Koch's postulates are fulfilled by that equation, yes.
Q. And that's Henle and Koch's postulate; isn't it, sir? They were two scientists in the 1800s; right?
Q. And they came up with postulates for what they called cause; correct?
Q. And one was that --
And this is based on 19th century knowledge of bacterial disease; correct?
Q. And they said that a parasite was a cause if it occurs in every case of the disease; correct?
Q. If it occurs in no other disease; correct?
A. I'm not sure of that.
Q. You don't know the Henle Koch postulates; do you, sir?
A. Yes, sir, I do know Koch's postulates.
Q. All right. That is the second postulate, isn't it, it occurs in no other disease?
A. It occurs in no other disease.
Q. That's the second one.
A. Of --
But that does not include the related diseases.
Q. And the third postulate was after being isolated from the body, grown in a pure culture and repeatedly passed, it would induce the disease again; correct?
A. Yes, sir.
Q. And those were the three Koch's postulates; correct?
A. I have so stipulated.
Q. All right. Now do you believe that the Epstein-Barr virus causes infectious mononucleosis?
A. Possibly, yes.
Q. You know it does; don't you, sir?
Q. Yes, you do.
And that was found by Werner Henle, Robert Henle -- or Jacob Henle's grandson; correct?
A. I don't know that.
Q. You don't know.
And not one of his grandfather's postulates was met by the -- by that virus; isn't that right, sir? Not one.
A. Well that doesn't have anything to do with my prior statement relative to the absolute relationship between smoking and lung cancer.
Q. But you just said that the Epstein-Barr virus causes infectious mononucleosis; didn't you?
Q. And it doesn't occur in every case of infectious mononucleosis; does it, sir?
A. That's why I hedged my initial answer to you. It doesn't occur in every case.
Q. And smoking doesn't cause in every smoker lung disease; does it?
A. No. As a matter of fact, in only a small minority.
Q. Now with regard to the Epstein-Barr virus, it occurred in other diseases; didn't it?
A. I don't understand the thrust of your question.
Q. Well I'm seeing whether or not, where you say that Epstein-Barr virus causes infectious mononucelosis -- causes -- whether it fits the Henle-Koch's postulates, and we're finding out that it doesn't fit the Henle Koch's postulates; aren't we, sir?
A. Yes. But I was talking about tuberculosis.
Q. Oh. Well, should we talk about typhoid or diphtheria?
A. No. I was talking about tuberculosis.
Q. How about cholera?
A. I was talking about tuberculosis.
Q. Scientists for decades have found cause regardless of whether the Henle Koch's postulates are met; haven't they doctor? If you can answer.
A. Mr. Ciresi, I don't want to argue with you about this.
Q. I'm not arguing either, sir. I've asked a simple question.
Scientists for decades --
MR. WEBER [attorney for the tobacco industry]: Object to the commentary again, Your Honor.
MR. CIRESI: Well, Your Honor, he said he didn't want to argue with me.
THE COURT: All right. You can ask the question.
BY MR. CIRESI:
Q. Scientists for decades have found cause and effect in the absence of Henle Koch's postulates; haven't they?
A. In some instances. But I wasn't referring to scientists and -- and the Koch's postulates, not "Koch's." I was talking about tuberculosis.
Q. I know you were.
A. That's a --
Q. I know you picked --
A. -- one-on-one equation.
Q. I know you picked tuberculosis, sir. I know that, the jury knows it, the court knows it.
MR. WEBER: Objection, your honor.
THE COURT: Ask a question, counsel.
BY MR. CIRESI:
Q. Now, do you know of any other cancer that has been researched epidemiologically, toxicologically, in other ways, over the last 40 years as lung cancer and smoking? Can you name any other disease?
A. I'm sorry, I don't understand your question.
Q. Do you know how many studies have been conducted on lung cancer and smoking?
A. How many studies?
A. No, I can't tell you that. But an infinite number.
Q. And sir, when scientists make judgment on causation, they don't look at just the Henle Koch's postulates; do they? They look at other factors, correct?
A. There are -- there are many factors, obviously.
Q. They look at the experimental approach; don't they?
Q. They look at the temporal associations; don't they?
Q. They look at consistency of associations; don't they?
A. I would think so.
Q. They look at the strength of those associations; don't they?
A. Yes, sir.
Q. They look at the coherence of the associations; don't they?
A. I imagine.
Q. And then they make a judgment based upon cause and effect; don't they?
Q. And the Surgeon General of the United States since 1964 has used those scientific methods in determining that smoking causes a variety of diseases; haven't they?
Q. Based on reports in the medical literature and the judgments of hundreds of scientists in this country and around the world; correct?
A. Many of those scientists were supported by CTR grants.
Q. Sir, is your answer yes?
Q. Thank you.Minnesota Tobacco Trial 1998 Feb. 19 / Putnam Pit
Causation and disease: a chronological journey. The Thomas Parran
Lecture. Evans AS. Am J Epidemiol 1978 Oct;108(4):249-258. The central
motif is that concepts of causation should keep up with technology.