There have been trends to equate normal with an ideal state of health, and disease with disturbances that are determined solely by subclinical abnormalities. While in any living language there is a conflict between established definition and the need for change, modification in the use of words that are of such central importance to medical writing requires cogent justification that has not been forthcoming in these instances. To avoid further obscuration of the literature, the term normal should be limited to its traditional connotation of average, and the term disease should be reserved for disturbances of health that are clinically manifest.