In the late 19th century, soon after bacteria were first shown to cause disease, a scientific witch-hunt began. In frenzied competition for glory and fame (but not yet NIH grants), scientists accused bacteria of causing all sorts of diseases. One embarrassing example is alcaptonuria, the classic inborn error of metabolism. Before Garrod, the black urine of affected patients was blamed on an intestinal bacterium that was said to convert tyrosine to homogentisic acid. To calm this finger-pointing frenzy, the bacteriologist Robert Koch established objective rules by which to indict an organism. The bacterium had to be isolated from an affected subject; it had to produce a disease when transmitted to an animal; and it had to be recoverable from the animal’s lesion. The common metabolic diseases, including atherosclerosis, hypertension, and adult-onset diabetes mellitus, have yet to emerge from the witch-hunt stage. Atherosclerosis, for one, has been blamed on everything from viruses to iron. These multifactorial diseases are more complex than the bacterial ones: most people can tolerate the offending agents, such as fat, salt, and sugar, without harm thanks to the protection of their genes. These agents cause disease only when the guardian genes are defective. To solve these multifactorial conspiracies, both the environmental provocateur and the derelict gene must be identified. And to convince the world of their joint culpability, rigorous proof must be provided, as Koch demanded. Molecular genetics has given us at last the opportunity to satisfy Koch’s postulates for multifactorial metabolic diseases. By manipulating genes in mice, living test tubes can be created to evaluate the combined effects of genes and environmental agents. The first step is to identify the environmental factor, which usually comes from a list of suspects gathered by epidemiologists operating on the principle of guilt by association. Next, candidate genes must be identified. The initial suspicion may come from knowledge of the metabolic pathway that normally handles the suspected environmental agent. Help can come from studying rare individuals with severe mutations that inactivate crucial genes and produce the disease without any environmental contribution. But to perform Koch’s test, both the genetic and environmental features of the disease must be reproduced in an animal, which is now possible in mice. In atherosclerosis research, molecular genetics has reached an advanced stage, and a leading example is found in this issue of Cell (Plump et al., 1992) and in a related article by Zhang et al. (1992) in the current issue of Science. Decades ago, epidemiologists found that high levels of blood cholesterol correlate with atherosclerosis in various populations. The level of blood cholesterol, in Minireview